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