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Home | Top 100 | TOP 100 ECG | ECG Case 050

ECG Case 050

by Dr Ed Burns, last update March 19, 2019

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


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About Dr Ed Burns

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

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