Potato Poisoning (Not due to Solanine in greens!). With Positive Modified Sgarbossa Criteria.

In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram, 13% had a QRS duration greater than 170 ms, and only 1% had a duration greater than 190 ms.Clinical CourseThe clinicians recognized this as hyperkalemia.  The lab result was too high to measure (greater than 9.4 mEq/L).p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 11.0px Helvetica; background-color: #fefefe}The patient received albuterol x 6, calcium gluconate x 5 g, D50 (50 ml) x 2, 5 units regular insulin, 40 mg furosemide, and 50 mL of Na bicarb.It turns out he had been told several days earlier that his K was low and so he had eaten several baked potatoes.  Baked potatoes have about 926 mg of K (boiled potatoes have 296 milligrams, and an average banana has 426 mg).  KCl is 74 mg per mEq, so the number of milliequivalents is far less, but a dialysis patient eating many baked potatoes is sufficient to substantially raise the K.After dialysis, this was the followup ECG:Normal, except V1 and V2 are recorded too high on the chest (fully negative P-wave in V1, negative P-wave in V2) and there is slight ST depression.
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs