ECG IN HYPERKALEMIA

HIGH POTASSIUM LEVEL IN ECG

Hyperkalemia is a harsh condition in which blood potassium levels are above normal in the blood. This is one of the common conditions during End-Stage Kidney Disease(ESKD). But due to some other causes also this condition may occur.
For example frequent uses of Trimethoprim-Sulfamethoxazole combination (Septrin, Septra, and Bactrim)may raise potassium level in the blood. Beware of these antibiotics if the patient is aged above 60 years.

Here we are about to see only how this condition is reflected in the ECG.

Fig-1

In the above Fig-1 a normal ECG has been shown. In that one can observe a normal sinus rhythm with a clear P, Q, R, S, and T-waves.

In the following Fig-2A and 2B each, an ECG has been taken during the condition of high potassium level in the blood.

Fig-2A

Fig 2B

In general hyperkalemia causes the reduction in heartbeats or frequency of contraction(cardiac chronotropic) and increasing the force of contractility (cardiac inotropy). It causes errors in cell polarization and depolarization. Irregular beats.Cardiac arrhythmias.Bradycardia or slowing of heartbeats. If left uncorrected it may result in cardiac arrest.

In the above Fig-2A, the precordial leads V3 and V4 show the stages of abnormalities develops in the sinus rhythm due to the high level of potassium in the blood.

The first stage shows normal P-wave with the abnormal decay of the QRS complex followed by the elevated T-wave.

The second stage shows the flattening of P-wave and the third stage shows the total eclipse of P-wave.

The QRS complex is shortened and narrowed.

T-wave is high peaked.

Segment-wise the PR-seg.is elongated and the ST-seg.is elevated to predict the event of a heart attack.

The P -wave disappearance is due to the atrial nonresponse to the SA node triggering.

The QRS shortening and narrowing indicate and predict ventricular fibrillation.

The elevated T-wave indicates the delay in ventricular repolarization.

Control potassium intake by avoiding potassium-rich foods such as unpeeled fruits, red meats, raisins, prunes, potatoes, and drinks like tender coconut, orange, banana, grapefruit, tomato, prune and apricot juices.

Symptoms of hyperkalemia are mild or asymptomatic at stage one 

but shows fatigue, tiredness, tingling and numbness, nausea and vomiting, breathing trouble, and chest pain.