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.

Check out the comments from our original post here.

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 ?

You can check out the patient's VBG at Emergucate's lab case of the week here.

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

• Hypokalaemia ECG here
• Hypokalaemia cases
• You Can Beat the Feeling
• D&V Now can't stand up
• Hypokalaemia & Metabolic Acidosis
• Hypokalaemia overview

Textbook

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