Saturday, May 20, 2017
A 63 year old with Hyperkalemia (potassium 7.4mEq/L) and a Paced Rhythm
A defining characteristic of hyperkalemia on an EKG is a tall, tented T wave. The T wave is peaked at the top and broader at the base. When the hyperkalemia is more profound, the QRS complex tends to widened and fuse with the T wave forming a sine wave.
The rhythm looks regular due to pacemaker. The pacing rate is about 100 bpm. There appears to be a first degree block. Upright P waves are seen in the continuous lead II strip at the bottom.
The patient was treated initially with calcium gluconate, IV insulin, and 50% dextrose. She is a hemodialysis patient and underwent urgent hemodialysis.