Electrolyte Disorders

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.

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  Consecutive ECGs of a patient with hypokalemia. ECG1

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  Consecutive ECGs of a patient with hypokalemia. ECG2

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

Hypokalemia

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  patient A

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  patient A

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  patient B

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