In the case presented here, the serum potassium was found to be significantly elevated and serves to explain the peaked T waves that normalized upon correction of the hyperkalemia. The corrected QT interval is either normal or shortened. These changes are often seen when the serum potassium exceeds 5.5 mEq/L.
Tall, narrow, and peaked T waves are the earliest ECG sign of hyperkalemia. The classic descriptions of hyperkalemia and hypocalcemia are listed in Table 1. Part of this prolongation was due to a prominent U wave. The appearance of the T waves was unusual with a prolongation of the descending limb of the T wave, merging into the next P wave. There were peaked T waves in the precordial leads. He was admitted to the intensive care unit for management of sepsis and initiation of chemotherapy.Ī 12‐lead ECG showed normal sinus rhythm at 80 beats/min ( Fig. Computed tomography of his abdomen revealed Richter's transformation of his CLL.
Ecg signs of hyperkalemia skin#
His abdomen was tender, distended, and the skin was mottled. His temperature was 37.9☌ and he required a FIO 2 of 60% to maintain a SaO 2 greater than 92%. On examination his blood pressure was 94/62 mmHg, his heart rate was 111 beats/min, and his respiratory rate was 22/min. He had recently been treated with prednisone for warm autoimmune hemolytic anemia.
A 62‐year‐old man with a history of chronic lymphocytic leukemia (CLL) presented to the Emergency Department complaining of a 4‐day history of vomiting and abdominal pain.
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