ECG Abnormalities

ECG Abnormalities



Pathology:                  Raised blood potassiumconcentration >5.5mmol/L


Aetiology:                    Increased production: Excess potassiumtherapy, blood transfusion

Decreased excretion: Renalfailure, hypoaldosteronism, Addison’s disease

Release from cells: DKA,metabolic acidosis, burns, rhabdomyolysis

Drugs:Potassium sparing diuretics, Beta blockers, ACE inhibitors, NSAIDS,



Symptoms:                  Non-specifice.g. nausea, malaise, muscle weakness


Signs:                             Ventricular Fibrillation, Kussmaul’s breathing


Investigations:          Bloods: FBC, U+E’s

                                        ECG:decreased P wave amplitude, tall tented T waves, widening of QRS complex

                                          ABG: May show acidosis


Treatment:                  Treat underlying cause

                                        K+ of >6.5 and any degreeof hyperkalaemia with ECG changes - urgent treatment


StabiliseMyocardium: 10ml 10% IV calcium gluconate

To lower K+: 10units of Insulin in 50mls 50% Dextrose, Salbutamol nebuliser

                            CalciumResonium. Haemodialysis in severe cases


Complications:          Sudden death  


Prognosis:                  Depends on aetiology






Rectangle: Rounded Corners: NOTE FOR PUBLISHERS – 

ECG of Hyperkalaemia showing classical ECG signs









Figure 1.11 ECG findings of Hyperkalaemia

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