Wednesday, 16 January 2019

ECG of the Week - 14th January 2019 - Interpretation

The following ECG is from a 45 yr old male who presented complaining of weakness and lethargy.



Click to enlarge

Rate:
  • 48 bpm
Rhythm:
  • Regular
  • Sinus bradycardia
Axis:
  • Normal
Intervals:
  • PR - Normal (~200ms)
  • QRS - Prolonged (120ms)
  • QT - 620ms
    • Apparent due to T-U fusion
Additional:

  • ST Depression leads I, II, aVF, V2-6
  • 'Down-up' T wave
    • Secondary to T-U fusion
  • Significant lead artifact in all precordial leads

Interpretation:

  • ECG features consistent with hypokalaemia

What happened ?

The patient had a K of 1.4 mmol/L !! They were admitted to critical care for monitoring during replacement.

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.

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