Electrocardiographic manifestations of severe hyperkalemia

Abstract

Severe hyperkalemia is a hazardous condition that warrants urgent intervention. In critically ill patients, the electrocardiogram (ECG) can be the most immediately available diagnostic tool in identifying patients with potentially lethal hyperkalemia. Peaking of the T waves, the most widely appreciated ECG sign, is actually rarely a manifestation of life-threatening hyperkalemia. In this review, we provide several clinical-electrocardiographic manifestations that can help identify those patients with hyperkalemia who require prompt intervention.

Keywords: Brugada phenocopy; Double-counting of heart rate; ECG; Hyperkalemia; Intraventricular conduction block; Non-shockable wide-complex tachycardia; Pseudo-infarction pattern; Pulseless electrical activity; Sine-wave.