emDocs - January 25, 2018 - Author: Singh M - Edited by: Santistevan J and Long B
"What are the main ECG pointers for hyperkalemia?
- Though it is good to know the classic ECG progression of hyperkalemia, do not be fooled by a normal or nonspecific ECG in hyperkalemia.
- The relationship between serum potassium and ECG manifestation is not cut and dry as we are taught. Don’t get into a false sense of security…treat the patient in front of you!
- Keep hyperkalemia in the differential diagnosis for a patient with an ECG showing a very wide QRS complex
- Keep in mind the differential of a “peaked” T-wave:
- Hyperkalemia
- Hyperacute T-waves from ischemia
- De Winter’s T-waves
- Benign Early Repolarization
- Hyperkalemia is a great mimicker – think about it in your STEMI-mimics, bradyarrhythmias, tachyarrhythmias, AV blocks, etc., especially if the ECG is not adding up on your interpretation."