Wednesday, 30 September 2015

ECG of the Week - 28th September 2015 - Interpretation


This week's ECG is from a 27 yr old female who presents with weakness and lethargy.


Click to enlarge



Rate:
  • 78
Rhythm:
  • Sinus arrhythmia
Axis:
  • Normal
Intervals:
  • PR - Normal (~140ms)
  • QRS - Normal (80ms)
  • QT - 410ms (QTc Bazette 465 ms)
Segments:
  • ST Elevation lead aVR
  • ST Depression leads II, III, aVF, V3-6

Additional:
  • U waves infero-lateral leads
Interpretation:
  • ECG features of hypokalaemia with a consistent clinical history
    • QTc Prolongation
    • U waves
    • ST segment changes

What did the patient's bloods show ?


Hypokalemia ECG's on the Web
  • ECG of the Week - We've had some examples of hypokalemia previous check them out here here.
  • Dr Smith's ECG Blog - multiple great examples of hypokalaemic ECGs here.
  • Dr Ken Grauer's ECG Interpretation - A great walk through of ECG changes in hypokalaemia here.
  • Amal Mattu's ECG Video - ECG findings in severe hypokalaemia here.


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.