ECG: Hyperkalemia
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1. A 30-year-old male with fever and altered mental status was found to have a potassium level disturbance based on his ECG. 2. ECG changes due to electrolyte imbalances can vary between individuals and depend on other electrolyte levels as well. 3. However, certain consistent ECG features often indicate increased or decreased potassium, making ECG useful for identifying electrolyte issues if prior tracings are available for comparison.
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ECG: Hyperkalemia
- 1. JAGDISH. K PROF. DR. A. GOWRISHANKAR’S UNIT ECG OF THE WEEK
- 2. 30 yr old male was brought with the chief complaints of fever, altered sensorium for the past 3 days. Patient was apparently alright 3 days ago. Known type 1 diabetic on Insulin.
- 3. Examination Patient was febrile, dyspneic, tachypneic, disoriented Pulse : 110/min BP : 100/60 mm of hg RR : 38/min CNS : disorientation + Neck rigidity + Other systems : normal
- 4. ECG
- 5. ECG changes in electrolyte imbalance is not very predictable. Change depends on the inter individual variation & on the other electrolytes too.
- 6. However certain ECG features often develop in conjunction with increased / decreased potassium concentration so that ECG may be frequently utilised for electrolyte disturbances particularly if the interpreter is thinking of electrolyte disturbances.
- 7. Accuracy of observation is enhanced if Control tracing available Serial tracings done
- 8. Hyperkalemia It has not been definitely established that the changes are due to Intracellular K + changes Gradient across cell membrane Potassium level in the serum alone
- 10. SA Nodal
- 11. Ventricular
- 13. K + changes & Action Potential curve
- 14. Changes during depolarisation & resting membrane potential
- 16. ECG changes Short QT interval Peaked T wave ST segment depression Lowering & widening of P wave Prolonged PR interval
- 17. QRS widening Short R wave & deep S wave Marching of QRS & T wave towards each other The Nadir of S wave & peak of T wave is connected by a straight line. Sine wave pattern Atrial fibrillation & Atrial arrest
- 19. Effect of other electrolytes Low Na + High Na +
- 20. Low Ca 2+ High Ca 2+
- 21. ECG
- 22. Sine wave