Wednesday, 20 June 2012

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

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.