ECG in hyperkalemia
In this ECG some features due to hyperkalemia are visible:
- Tall T waves – T waves in anterior leads are as tall as or taller than the QRS complexes, though the absolute amplitudes are not very high. Typical description in hyperkalemia is tall tented T waves.
- QRS widening, with right bundle branch block like pattern
- Lack of atrial electrical activity – no P waves are visible and there is bradycardia. It could very well be a slow junctional rhythm. Ideally if there was sinus arrhythmia visible in the QRS complex intervals, one could have presumed that there is sinus node activity with atrial paralysis and sinoventricular condition.
In severe hyperkalemia, QRS becomes very wide and merges with T wave to produce a sine wave pattern in which there will be no visible ST segment. But in this ECG a clearcut ST segment is quite evident.