The QRS will widen and the rate will slow. Serum K levels of 7.0 mEq/L or greater can cause conduction abnormalities. The P waves will lose amplitude, widen and flatten. Serum K levels of 6.5 mEq/L or greater cause progressive paralysis of the atria. Serum K levels of 5.5 mEq/L or greater can cause repolarization abnormalities like tall, peaked T waves. Occasionally, serum K levels may be artificially elevated by drawing the blood with too much syringe pressure, or using too small a needle, as the red blood cells can be damaged and release intracellular K into the serum.ĮCG signs may vary among people with hyperkalemia, but in general: Extracellular serum potassium can rise due to renal failure, or taking potassium supplements, potassium-sparing diuretics, or ACE inhibitors. It is necessary for proper electrical functioning of the heart. Potassium is primarily an intracellular electrolyte. Caution: hyperkalemia can progress and become life-threatening very quickly. It is a bit surprising that the QRS complexes have not yet widened at this serum K level. At this level of hyperkalemia, we can expect to see conduction disturbances (first-degree AV block in this case) and bradycardia (not yet). The P waves have not yet widened and lost amplitude, but they will soon flatten out and disappear. There are tall, sharply-peaked T waves in many leads. It shows some of the earliest ECG signs of hyperkalemia. This ECG was obtained from a patient who had a serum potassium level of 7.4 mEq/L.
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