In this condition, as summarized by Figure 1, ECG changes, including expansive QRS complex, peaked T-wave, prolonged QT-interval, and hidden p-wave might be initiated. In this review, we summarize and evaluate the studies on electrocardiogram changes following potassium disorders.Īccording to many studies, hyperkalemia strongly correlates with ECG manifestations. Severe hyperkalemia and hypokalemia can threaten life, and immediate diagnosis and treatment are required. In authoritarian states, cardiac arrest occurs in systole. In hypokalemia conditions (potassium levels become lower than 3.5 mmol/L), the cardiac cells hyperpolarise with a reduction in muscular contraction, heart rate, and blood pressure. In hyperkalemia conditions (potassium levels become higher than 5 mmol/L), the cardiac cells depolarise with almost no regular repolarization, which causes muscular weakness and in severe states, causes cardiac arrest in diastole. Therefore, increasing plasma potassium reduces this ratio, as a result, increases cell membrane excitability. Membrane resting potential is related to the difference between intracellular and extracellular potassium concentrations. Its increase or reduction has profound effects on the electrophysiology of cardiac muscle. The electrical stability of the heart is sensitive to potassium concentration. One essential electrolyte that impact transmembrane potential in cardiac cells is potassium concentration. A significant ratio of cardiac arrests in adult patients with no coexisting cardiac disorder is due to metabolic abnormalities. Nowadays, ECG changes are one of the useful diagnostic clues for recognizing electrolyte abnormalities. Myocardial cells keep up their activity of depolarization and repolarization, by developing several essential electrolytes like potassium, sodium, and calcium their currents across the membrane can be announced by ECG. Manifestations change in hyperkalemia, for correct diagnosis clinical history of the patients is essential. ECG Changes in severe hyperkalemia that can endanger patients’ lives are noteworthy. The studies showed peaked T wave, as well as expanded QRS complex and low P amplitude, are important changes that can guide us to immediate diagnosis. Moreover animal studies on ECG changes related to hyper- and hypokalemia are provided. In this review, we summarized ECG changes related to hyperkalemia and interventions. The current review summarizes studies to elucidate the correlation between potassium disorders and ECG demonstrations. Potassium disorders, including hyperkalemia and hypokalemia in authoritarian states, may lead to heart dysfunctions and could be life-threatening, and urgent interventions are needed in this conditions. Potassium is one of the essential electrolytes in cardiac cells, and its variations affect ECG. !! Suspect hyperkalaemia in any patient with a new bradyarrhythmia or AV block, especially patients with renal failure, on haemodialysis or taking any combination of ACE inhibitors, potassium-sparing diuretics and potassium supplements.ĮCG 1 Hyperkalemia 6.5 mmol/l in a patient with chronic renal failure (slight ST elevations in I, II, avL, peaked T waves in I, II, aVF, V2-V6)ĮCG 1 Hyperkalemia 6.Nowadays, electrocardiogram (ECG) changes are one of the valuable diagnostic clues for recognizing abnormalities. Sensitivity of ECG changes is not very high - 34-43%, but specificity is about 85%. Intraventricular/fascicular/bundle branch blocks.ST elevations that can mimic STEMI / ST depressionsĪt a serum potassium level higher than 8.0 mmol/l, the ECG shows the following.Tall, peaked T waves with a narrow base, best seen in precordial leadsĮCG changes if blood potassium is 6.5-8.0 mmol/l.Hyperkalemia = potassium level > 5.5 mmol/lĮCG findings generally correlate with the potassium level, but potentially life-threatening arrhythmias can occur without warning at almost any level of hyperkalemia.Įarly ECG changes of hyperkalemia (5.5-6.5mmol/l) A shift of potassium from the intracellular to the extracellular space.Hyperkalemia can result from any of the following reasons, which often occur in combination: When present, symptoms are nonspecific and predominantly related to muscular or cardiac function. Most patients with hyperkalemia slightly over 5 mmol/l are asymptomatic. Hyperkalemia is an electrolyte abnormality with adverse clinical outcome or death if not treated properly.
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