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Review
. 2018 Sep-Oct;51(5):814-817.
doi: 10.1016/j.jelectrocard.2018.06.018. Epub 2018 Jul 4.

Electrocardiographic manifestations of severe hyperkalemia

Laszlo Littmann  1 , Michael A Gibbs  2
Affiliations
Review

Electrocardiographic manifestations of severe hyperkalemia

Laszlo Littmann et al. J Electrocardiol. 2018 Sep-Oct.

Abstract

Severe hyperkalemia is a hazardous condition that warrants urgent intervention. In critically ill patients, the electrocardiogram (ECG) can be the most immediately available diagnostic tool in identifying patients with potentially lethal hyperkalemia. Peaking of the T waves, the most widely appreciated ECG sign, is actually rarely a manifestation of life-threatening hyperkalemia. In this review, we provide several clinical-electrocardiographic manifestations that can help identify those patients with hyperkalemia who require prompt intervention.

Keywords: Brugada phenocopy; Double-counting of heart rate; ECG; Hyperkalemia; Intraventricular conduction block; Non-shockable wide-complex tachycardia; Pseudo-infarction pattern; Pulseless electrical activity; Sine-wave.

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Comment in

  • Hyperkalaemia and cardiac pacing.
    Tomcsányi J, Bózsik B. Tomcsányi J, et al. J Electrocardiol. 2018 Nov-Dec;51(6):1154. doi: 10.1016/j.jelectrocard.2018.08.015. Epub 2018 Aug 13. J Electrocardiol. 2018. PMID: 30177368 No abstract available.
  • More on the pacemaker ECG in severe hyperkalemia.
    Littmann L, Gibbs MA. Littmann L, et al. J Electrocardiol. 2018 Nov-Dec;51(6):1156-1157. doi: 10.1016/j.jelectrocard.2018.09.007. Epub 2018 Sep 11. J Electrocardiol. 2018. PMID: 30224191 No abstract available.

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