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Electrocardiographic manifestations of severe hyperkalemia

Journal

JOURNAL OF ELECTROCARDIOLOGY
Volume 51, Issue 5, Pages 814-817

Publisher

CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.jelectrocard.2018.06.018

Keywords

ECG; Hyperkalemia; Intraventricular conduction block; Pseudo-infarction pattern; Brugada phenocopy; Double-counting of heart rate; Sine-wave; Pulseless electrical activity; Non-shockable wide-complex tachycardia

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Severe hyperkalemia is a hazardous condition that warrants urgent intervention. In critically ill patients, the electrocardiogram (ECG) can be the most immediately available diagnostic tool in identifying patients with potentially lethal hyperkalemia. Peaking of the T waves, the most widely appreciated ECG sign, is actually rarely a manifestation of life-threatening hyperkalemia. In this review, we provide several clinical-electrocardiographic manifestations that can help identify those patients with hyperkalemia who require prompt intervention. (C) 2018 Elsevier Inc. All rights reserved.

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