Elderly patient feeling generally unwell. PMHx of T2DM, hypertension, IHD, CCF, osteoarthritis. Describe the ECG.
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
- Bizarre appearing complexes.
- Marked T wave peaking in V2-6.
- Gross QRS prolongation (~200 ms).
- Some leads (I, aVR) are starting to take on a sine wave appearance.
The combination of…
- Bizarre complexes
- QRS prolongation
- Peaked T waves
- Sine wave appearance
… are all strongly suggestive of severe hyperkalemia.
This patient had a serum K of 9.2 mmol/L!
In this elderly patient with multiple medical problems, causes could include renal failure (e.g. due to diuretics, NSAIDs, intercurrent illness) or treatment with ACE-inhibitors, spironalactone or K-supplements.