Past medical history of hypertension and mild chronic renal impairment.
Thanks to Dr Anand Senthi for sharing this ECG case.
Check out the comments from our original post here.
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| Click to enlarge |
- ~90 bpm
- Regular
- Sinus rhythm
- P waves best seen in the inferior leads
- P waves difficult to see in the precordial and high-lateral leads
- Normal
- PR - Prolonged (~240ms)
- QRS - Prolonged (120ms)
- QT - ms (QTc Bazette 380-400 ms)
- Nil significant abnormality
- Not typical LBBB or RBBB morphology given QRS widening
- Peaked T waves leads V2-6
Interpretation:
What happened ?
The patient had an urgent VBG which showed a K+ of 8.0 mmol/L ! Therapy with calcium gluconate, nebulised salbutamol and insulin/dextrose was commenced.
Following treatment the ECG was repeated as is shown below:
This ECG shows resolution of PR prolongation, QRS widening and T wave peaking seen on the first ECG.
References / Further Reading
Life in the Fast Lane
Textbook
- ECG Features suggestive of hyperkalaemia
What happened ?
The patient had an urgent VBG which showed a K+ of 8.0 mmol/L ! Therapy with calcium gluconate, nebulised salbutamol and insulin/dextrose was commenced.
Following treatment the ECG was repeated as is shown below:
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| ECG Post Treatment of Hyperkalaemia Click to enlarge |
This ECG shows resolution of PR prolongation, QRS widening and T wave peaking seen on the first ECG.
References / Further Reading
Life in the Fast Lane
Textbook
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
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