Hypokalemia electrocardiogram: Difference between revisions
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{{Hypokalemia}} | {{Hypokalemia}} | ||
{{CMG}}'''; Associate Editor-In-Chief:''' {{CZ}}; '''Assistant Editor(s)-In-Chief:''' [[User:Jack Khouri|Jack Khouri]] | {{CMG}}'''; Associate Editor-In-Chief:''' {{CZ}}; '''Assistant Editor(s)-In-Chief:''' [[User:Jack Khouri|Jack Khouri]] | ||
==Overview== | |||
*Caused mainly by delayed ventricular repolarization | *Caused mainly by delayed ventricular repolarization | ||
*Seen at potassium levels <3 meq/L (90% of patients with potassium levels <2.7 meq/L have abnormal ECG findings) | *Seen at potassium levels <3 meq/L (90% of patients with potassium levels <2.7 meq/L have abnormal ECG findings) | ||
*Rapidly reversible with potassium repletion | *Rapidly reversible with potassium repletion | ||
==ECG changes== | |||
# ST segment depression, decreased T wave amplitude, prominent U waves | # ST segment depression, decreased T wave amplitude, prominent U waves | ||
#* seen in 78% of patients with a K < 2.7 meq | #* seen in 78% of patients with a K < 2.7 meq | ||
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# Contrary to popular belief there is not prolongation of the QTc, this is artifactually prolonged due to the U wave. In some cases there is fusion of the T and the U wave making interpretation impossible. | # Contrary to popular belief there is not prolongation of the QTc, this is artifactually prolonged due to the U wave. In some cases there is fusion of the T and the U wave making interpretation impossible. | ||
==ECG Imaging== | |||
<div align="center"> | <div align="center"> | ||
<gallery heights="175" widths="175"> | <gallery heights="175" widths="175"> | ||
Revision as of 19:18, 7 December 2011
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Hypokalemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hypokalemia electrocardiogram On the Web |
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American Roentgen Ray Society Images of Hypokalemia electrocardiogram |
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Risk calculators and risk factors for Hypokalemia electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Assistant Editor(s)-In-Chief: Jack Khouri
Overview
- Caused mainly by delayed ventricular repolarization
- Seen at potassium levels <3 meq/L (90% of patients with potassium levels <2.7 meq/L have abnormal ECG findings)
- Rapidly reversible with potassium repletion
ECG changes
- ST segment depression, decreased T wave amplitude, prominent U waves
- seen in 78% of patients with a K < 2.7 meq
- seen in 35% of patients with a K > 2.7 and < 3.0
- seen in 10% of patients with a K > 3.0 and < 3.5
- U waves are also prominent in bradycardia and LVH
- Prolongation of the QRS duration
- uncommon except in severe hyperkalemia
- Increase in the amplitude and duration of the P-wave
- Cardiac arrhythmias and AV block
- Contrary to popular belief there is not prolongation of the QTc, this is artifactually prolonged due to the U wave. In some cases there is fusion of the T and the U wave making interpretation impossible.
ECG Imaging
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Long QT interval, ST segment depression, low T waves amplitude and TU wave fusion in a hypokalemic patient.
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Consecutive ECGs of a patient with hypokalemia. ECG1
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Consecutive ECGs of a patient with hypokalemia. ECG2
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Consecutive ECGs of a patient with hypokalemia. After correction of potassium levels.
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Hypokalemia with LVH. Image courtesy of Dr Jose Ganseman
