ECG Guru - Instructor Resources - Sine wave https://www.ecgguru.com/ecg/sine-wave en Extreme Hyperkalemia https://www.ecgguru.com/ecg/extreme-hyperkalemia <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/extreme-hyperkalemia"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Wide%20Complex%20Rhythm%20Hyperkalemia.jpg" width="1800" height="1279" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal">This ECG was taken from an elderly man who was in acute renal failure, and had presented to the Emergency Department via EMS.&nbsp; He was weak and hypotensive.&nbsp; We have no other medical history or clinical information.<span style="font-size: 8pt; line-height: 107%;">&nbsp;</span></p><p class="MsoNormal">The most noticeable feature of this ECG is the wide QRS, which is difficult to measure because there is no distinct J point at the end of the QRS complex.&nbsp; As a result, the QRS blends into the ST segment and T wave.&nbsp; The T waves are extremely wide.&nbsp; At a rate of 61 bpm, it is almost bradycardic. It appears that P waves may be present in some leads (like Lead II) - but, if so, the PR interval looks short.&nbsp; It is difficult to tell where the P wave ends and the QRS begins.&nbsp; Also, there are occasional pacer spikes, which are not capturing. &nbsp;&nbsp;<span style="font-size: 8pt; line-height: 107%;">&nbsp;</span></p><p class="MsoNormal">This is the “sine wave” rhythm of extreme hyperkalemia.&nbsp; This pattern usually appears when the serum potassium levels are well over 8.0 mEq/L.&nbsp; Had we seen the earlier ECGs, we might have had more warning, because the ECG in earlier stages of hyperkalemia shows us distinctive peaked, sharp T waves and a progressive intraventricular conduction delay (IVCD). &nbsp;<span style="color: #00b0f0;"><a href="http://ecgguru.com/ecg/hyperkalemia-1">See example</a></span>. The intervals progressively widen, the P waves lose amplitude until they disappear altogether.&nbsp; It is as if someone is holding the tracing at each end, and stretching it apart.<span style="font-size: 8pt; line-height: 107%;">&nbsp;</span></p><p class="MsoNormal">At this stage, this is an immediately life-threatening condition, but usually treatable.&nbsp; Quick action must be taken to prevent cardiac arrest.</p><p>&nbsp;</p><p class="MsoNormal">&nbsp;</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/666/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Extreme Hyperkalemia 1/5</option><option value="40">Give Extreme Hyperkalemia 2/5</option><option value="60">Give Extreme Hyperkalemia 3/5</option><option value="80">Give Extreme Hyperkalemia 4/5</option><option value="100" selected="selected">Give Extreme Hyperkalemia 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4.3</span></span> <span class="total-votes">(<span >6</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-3QgnyNWL0Ux-Ijt-qRzrMafZZRrom_rUsK10w33PNN0" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/wide-complex-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Wide-complex rhythm</a></div><div class="field-item odd"><a href="/ecg/hyperkalemia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Hyperkalemia</a></div><div class="field-item even"><a href="/ecg/sine-wave" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Sine wave</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fextreme-hyperkalemia&amp;title=%20Extreme%20Hyperkalemia"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Sun, 01 May 2016 19:19:04 +0000 Dawn 697 at https://www.ecgguru.com https://www.ecgguru.com/ecg/extreme-hyperkalemia#comments