This post is an answer to the ECG Case 239
- Rate: ~90 bpm
- Rhythm:
- Regular
- Sinus rhythm
- P waves best seen in the inferior leads
- P waves difficult to see in the precordial and high-lateral leads
- Axis: Normal
- Intervals:
- PR – Prolonged (~240ms)
- QRS – Prolonged (120ms)
- QT – ms (QTc Bazette 380-400 ms)
- Segments: Nil significant abnormality
- Additional:
- Not typical LBBB or RBBB morphology given QRS widening
- Peaked T waves leads V2-6
Interpretation
ECG Features suggestive of hyperkalaemia.
What happened next?
The patient had an urgent VBG which showed a K+ of 8.0 mmol/L ! Therapy with calcium gluconate, nebulised salbutamol and insulin/dextrose was commenced.
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