Presentation on theme: "Electrolyte abnormalities and ECG"— Presentation transcript:
1Electrolyte abnormalities and ECG Elias Hanna, MDLSU Cardiology
2Hyperkalemia: T wave in hyperkalemia is typically tall and narrow, but does not have to be tall(may be just narrow andpeaked pulling ST segment).Tall T means > 2 big boxes inthe precordial leads or >1small box in limb leads,or T wave taller than QRS.
3Hypokalemia: ST depression with prominent T Flat T with K~3 (actually U) and prolonged QTwhen K<2.5-3Flat T with K~3
4-T progressively flattens Hypokalemia:-T progressively flattens-U wave more and more prominent (looks like T)-ST-segment more and more depressedLarge U wave simulates and hides T wave with severe hypokalemia, the ST-T patternmay mimick:ST-segment depression with a flat or upright wide “T” wave (actually U)and a prolonged “QT” interval (actually QTU)
5On the other hand, the pattern of T inversion is not seen with hypokalemia:
6ECG changes of digoxin effect (digoxin therapy) simulate the changes seen with hypokalemia (U wave and ST depression), except that with digoxin therapy QT is not prolonged
7Hypocalcemia:Long QT that is due to a long ST segment, which is different from long QT due to congenital long QT syndrome, drugs, or hypokalemia. T wave is not wide, there is no T wave abnormality.
8Hypercalcemia: short QTc <390 ms Hypercalcemia: short QTc <390 ms. No significant ST or T wave abnormality
9Hypomagnesemia is not associated with characteristic or specific ECG findings It is associated with a non-specific prolongation of QT and/or QRS intervals, and is often associated with hypokalemia and hypocalcemia. Therefore, changes related to the latter 2 abnormalities may be seen.