ECG Case 050

Elderly patient presenting with collapse. Clinically dehydrated. Describe the ECG.

TOP 100 ECG QUIZ LITFL 050 2

Describe and interpret this ECG

ECG ANSWER and INTERPRETATION

This is a classic sine wave ECG of critical hyperkalaemia

  • Bradycardia (~ 55 bpm).
  • Bizarre-looking QRS complexes.
  • Gross QRS prolongation (> 300 ms).
  • Massively peaked T waves.

This patient had a K+ of 9.9 mmol/L!


CLINICAL PEARLS

Any time you see an ECG that is…

  • Blocked (AV block, bundle branch block)
  • Bradycardic (sinus brady, slow AF, junctional bradycardia)
  • Bizarre in appearance

… consider hyperkalaemia and check the K+ urgently!


TOP 100 ECG SERIES


Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |

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