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Hyperkalaemia: ECG changes, causes and treatment
Recent articles on:
Fluid and electrolyte balance
Fluid and electrolyte balance
Abstract
ECG changes reflecting hyperkalaemia include peaked T-waves, increased PR and QRS intervals, flattened P-waves and widened QRS complex, with merging of the QRS complex with the T-wave resulting in a sinusoidal pattern.
Key Points
- Hyperkalaemia may be caused by errors in collection or specimen processing, increased total body potassium or a compartmental shift of potassium from the cells to the extracellular fluid (ECF).
- Several medications are associated with hyperkalaemia, particularly NSAIDs, ACE inhibitors, angiotensin receptor blockers, aldosterone antagonists and potassium-sparing diuretics. These cause hyperkalaemia by decreasing output and/or affecting the potassium balance between the intracellular fluid (ICF) and ECF.
- ECG changes reflecting hyperkalaemia include peaked T-waves and slowing of conduction that increases the PR and QRS intervals, flattens the P-waves and widens the QRS complex so that it merges with the T-wave causing a sinusoidal pattern.
- Treatment of hyperkalaemia includes emergency measures to correct the electrophysiological effects, measures to shift potassium from the ECF to the ICF, and measures to reduce total potassium.
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