ECG of the Week - 18th June 2012 - Interpretation

This weeks ECG is from a 45 year old female with a 3 days history of progessive weakness and difficulty mobilising.

Click to enlarge

Rate:

• 84

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• Normal (+70 deg)

Intervals:

• PR - Prolonged (~220ms)
• QRS - Normal (100ms)
• QT - 300ms (QTc Bazette ~ 320ms)

Segments:

• ST downward slurring V3-6, II

Additional:

• qS V1
• T wave flattening II, III, V4-6
• Prominent U waves V2-3
• Prominent p waves in leads II, III

Interpretation:

• ECG changes consistent with hypokalaemia
• Also QT shortening ? hypercalcaemia

  

• This patient's potassium was 1.1 mmol/L

References / Further Reading

Life in the Fast Lane ECG Library

• Hypokalaemia here
• Hypercalcaemia here

Life in the Fast Lane Clinical Cases

• Metabolic Muddle 2 here
• Metabolic Muddle 6 here
• Pediatric Perplexity 10 here
• ECG Exigency 12 here

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.