What are these hyperacute T waves, with STE and T-wave inversion in aVL, and STD in inferior leads?
I was reading EKGs on the system and came across this one:What do you think?This is diagnostic of hyperkalemia. HyperK can result in all sorts of pseudoSTEMI or pseudoOMI patterns, including ST elevation, ST depression, and large T-waves.These T-waves are tall but have a narrow base and a corresponding flat ST segment (see lead V4). Also, there are no definite P-waves and this is another result of hyperkalemia. In fact, sometimes the sinus node is working and acting as a pacemaker but no P waves are visible!! This is called sino-ventricular rhythm. See these 3 other posts of sinoventricular rhythmThe K came back at 6.2 mEq/L.The patient was treated.He ruled out for MI by troponins.No followup EKG was recorded!!See many examples of Pseudo STEMI due to hyperkalemia at these two posts:Acute respiratory distress: Correct interpretation of the initial and serial ECG findings, with aggressive management, might have saved his life." Steve, what do you think of this ECG in this Cardiac Arrest Patient? "===================================MY Comment by KEN GRAUER, MD (8/4/2022):===================================One of the most common " ECG Emergencies " entails prompt recognition of Hyperkalemia — with our goals being:i) Avoidance of misdiagnosis (ie,mistaking tall, peaked T waves for deWinter T waves — as seemed to occur in today ' s case); and, ii) Prompt treatment of this potentially lif...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Steve Smith Source Type: blogs