ECG Question-1

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What is the most probable diagnosis of ECG given below?

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A. Hypercalcemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypokalemia

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Mikael Häggström, Public domain, via Wikimedia Commons

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Mild to moderate hyperkalemia – prolongation of the PR interval and development of peaked T waves.

Severe hyperkalemia- widening of the QRS complex

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What is the mechanism of tenting of the T waves in hyperkalemia?

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A. Faster depolarisation

B. Slower repolarisation

C. Faster repolarisation

D. Slower repolarisation

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What is the mechanism of smaller P waves and widening of the QRS complex in hyperkalemia?

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A. Inactivation of potassium channels

B. Inactivation of sodium channels

C. Inactivation of calcium channels

D. Inactivation of Calcium-activated potassium channels

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Peaked T waves in hyperkalemia are best seen in

A. Lead -I

B. Lead- II

C. aVF

D. Precordial leads

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What are the classic ECG changes associated with hyperkalemia?

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1. Peaked T wave,
2. Shortened QT interval,
3. Lengthened PR interval,
4. Increased QRS duration,

sine wave – absence of the P wave with the QRS complex seen as a ‘sine wave’.

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What are the ECG findings associated with adverse outcomes?

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Following ECG findings are associated with increased risk of adverse outcomes –

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1. Bradycardia,
2. junctional rhythms
3. QRS widening

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Hyperkalemia severity –

Degree of hyperkalaemia		Potassium level (mmol/L)
Mild		5.3 – 6.0
Moderate		6.0 – 6.9
Severe		≥ 7.0