ECG - cases

 




Complete heart block due to hyperkalemia , spo2 93% , pr 30 , bp undetectable ,hb 5.5

interpretation : regular rhythm , absent p wave , very slow hr , wide qrs , idioventricular rhythm (ventricular escape rhythm), peaked T wave 

management : urgent dialysis if there no c/i 


acute flaccid paralysis , +ve reflexes

interpretation: prominant U wave , flat T wave ,  

dx: hypokalemic periodic paralysis

management : KCL replacement diluted in mannitol 5% , iv potassium chloride 0.05-0.1mEq/kg in 5%mannitol as bolus preferable to continuous infusion , mannitol as solvent , because both N/S , GW worsen the attack , maximum KCL 200mEq per day , only 10mEq at time should infused in 20-60min,unless situations of cardiac arrhythmia or cardiac compromise (to avoid hyperkalemia) , continuous ECG monitoring and sequential serum K are mandatory 


another case of hypokalemia with prominant U wave and inverted T wave

Comments