Electrolyte Disorders: Difference between revisions

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===Hypercalcemia===
==Hypercalcemia==
Hypercalcemia results in a faster repolarization. Characteristics of hypercalcemia:
Hypercalcemia results in a faster repolarization. Characteristics of hypercalcemia:
*mild: broad based tall peaking T waves
*mild: broad based tall peaking T waves
*severe: extremely wide QRS, low R wave, disappearance of p waves, tall peaking T waves.
*severe: extremely wide QRS, low R wave, disappearance of p waves, tall peaking T waves.


===Hypocalcemia===
==Hypocalcemia==
ECG-characteristics of hypocalcemia:
ECG-characteristics of hypocalcemia:
*narrowing of the QRS complex
*narrowing of the QRS complex
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*prolonged ST and ST-depression
*prolonged ST and ST-depression


===Hyperkalemia===
==Hyperkalemia==
[[Image:ecg_hyperkaliemie.jpg|thumb| Extreme hyperkalemia. No p-waves, wide QRS, tall peaking T waves.]]
[[Image:ecg_hyperkaliemie.jpg|thumb| Extreme hyperkalemia. No p-waves, wide QRS, tall peaking T waves.]]
[[Image:ecg_hyperkaliemie2.jpg|thumb| Same patient after partial correction of the potassium level. Still no p-waves visible, wide QRS, tall peaking T waves.]]
[[Image:ecg_hyperkaliemie2.jpg|thumb| Same patient after partial correction of the potassium level. Still no p-waves visible, wide QRS, tall peaking T waves.]]
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===Hypokalemia===
==Hypokalemia==
[[Image:KJcasu18-3.jpg|thumb| Consecutive ECGs of a patient with hypokalemia. ECG1]]
[[Image:KJcasu18-3.jpg|thumb| Consecutive ECGs of a patient with hypokalemia. ECG1]]
[[Image:KJcasu18-2.jpg|thumb| Consecutive ECGs of a patient with hypokalemia. ECG2]]
[[Image:KJcasu18-2.jpg|thumb| Consecutive ECGs of a patient with hypokalemia. ECG2]]

Revision as of 13:09, 28 April 2008

Author(s) J.S.S.G. de Jong
Moderator T.T. Keller
Supervisor
some notes about authorship

Hypercalcemia

Hypercalcemia results in a faster repolarization. Characteristics of hypercalcemia:

  • mild: broad based tall peaking T waves
  • severe: extremely wide QRS, low R wave, disappearance of p waves, tall peaking T waves.

Hypocalcemia

ECG-characteristics of hypocalcemia:

  • narrowing of the QRS complex
  • reduced PR interval
  • T wave flattening and inversion
  • prolongation of the QT-interval
  • prominent U-wave
  • prolonged ST and ST-depression

Hyperkalemia

Extreme hyperkalemia. No p-waves, wide QRS, tall peaking T waves.
Same patient after partial correction of the potassium level. Still no p-waves visible, wide QRS, tall peaking T waves.

ECG characteristics of hyperkalemia:

  • Tall peaked T waves
  • Flattening p-waves. In extreme hyperkalemia p-waves may disappear altogether.
  • Prolonged depolarization leading to QRS widening (nonspecific intraventricular conduction defect) sometimes > 0.20 seconds

At concentrations > 7.5 mmol/L atrial and ventricular fibrillation can occur.

Hypokalemia

Consecutive ECGs of a patient with hypokalemia. ECG1
Consecutive ECGs of a patient with hypokalemia. ECG2
Consecutive ECGs of a patient with hypokalemia. After correction of potassium levels.

Hypokalemia is a low blood potassium level. This results in:

  • ST depression and flattening of the T wave
  • Negative T waves
  • A U-wave may be visible