It revealed tall peaked T wave, loss of P wave, and extreme widening of the QRS complex (0.180 s) however, life‐threatening arrhythmia did not occur. Other laboratory data are shown in Table 1. (irregular rhythm) blood pressure 83/42 mmHg initial serum potassium level 10.1 mmol/L. On admission, he was lucid with the following vital data: heart rate 42 b.p.m.

He had been taking a renin–angiotensin–aldosterone system (RAAS) inhibitor for several years. In the past year, his usual serum potassium levels (mmol/L) had ranged from 5.1–6.2. His morbidity history included hypertension, colectomy for rectal cancer, and CRF. The morphology of T wave and P wave were normal, and duration of the QRS complex was within normal range.Ī 59‐year‐old man was admitted with a 2‐day history of muscular weakness. The ECG at the serum potassium level of 5.6 mmol/L is shown in Fig. The patient's serum potassium level was 8.1 mmol/L at 1 h after starting treatment, and 5.6 mmol/L at 3 h after starting emergent hemodialysis. After initial treatment with 10 U regular insulin and 10 mL of 8.5% calcium gluconate hydrate, we began emergent hemodialysis. Severe hyperkalemia was caused by an over‐consumption of fruit. It revealed a tall peaked T wave, loss of P wave, and extreme widening of the QRS complex (0.256 s) however, life‐threatening arrhythmia did not occur. (irregular rhythm) blood pressure 98/64 mmHg serum potassium level 9.8 mmol/L. On admission, she was lucid with the following vital data: heart rate 42 b.p.m.

She had been taking a beta‐blocker for several years. In the past year, her usual serum potassium levels (mmol/L) had ranged from 4.0–6.6. Her morbidity history included hypertension, non‐insulin‐dependent diabetes mellitus, and chronic renal failure (CRF) on hemodialysis. Here, we present the ECG findings of two patients with serum potassium levels of nearly 10.0 mmol/L, and discuss the factors affecting ECG changes.Ī 63‐year‐old woman was admitted with a 2‐day history of muscular weakness. 3 reported that 43% of patients with potassium values less than 6.8 mmol/L showed ECG changes, and 55% of patients with levels higher than 6.8 mmol/L showed characteristic hyperkalemic ECG changes. However, these ECG abnormalities are not always observed in patients with hyperkalemia, and the relationship between serum potassium levels and ECG abnormalities is controversial.

1 In general, tall peaked T waves can be seen in patients with serum potassium levels above 5.5 mmol/L, loss of P waves are seen at levels of 6.5–7.5 mmol/L, widening of the QRS complex is observed at levels of 7.5–8.5 mmol/L, and life‐threatening arrhythmia occurs at serum potassium levels above 8.5 mmol/L. 1 The typical electrocardiogram (ECG) abnormalities in patients with severe hyperkalemia are tall peaked T waves, loss of P wave, and widening of the QRS complex. Echocardiography demonstrated a reduced left ventricular ejection fraction of 35% and normal regional wall motion.Severe hyperkalemia is defined as a serum potassium level greater than 8.0 mmol/L. A 12-lead electrocardiogram (ECG) was obtained at the time of admission ( Figure 1). Severe bilateral pulmonary congestion was noted on chest radiography. Initial laboratory evaluation revealed an elevated potassium level of 9.0 mmol/L and a creatinine level of 2.8 mg/dL. Physical examination was remarkable for an elevated jugular venous pressure, bilateral pulmonary basilar crackles, and lower extremity pitting edema. Vital signs on admission were significant for hypoxia with an oxygen requirement of 4 L/min, blood pressure of 130/79 mm Hg, and heart rate of 90 bpm. He denied any chest pain, palpitations, or syncope. A man in his 60s with a history of end-stage renal disease status post–renal transplant, atrial fibrillation, and sick sinus syndrome status after dual-chamber pacemaker placement presented to the emergency department complaining of progressively worsening dyspnea and diarrhea of 1 week’s duration.

Hyperkalemia ecg findings