Electrolyte and metabolic ECG abnormalities

Electrolyte and metabolic ECG abnormalities
Precise guide for Allied Health Science Students especially cardiac specialty students, DGNM, B.Sc Nursing & M.Sc Nursing Students .

1. Electrolyte and metabolic ECG abnormalities Mr. Aby Thankachan,M.Sc (N), Ph.D (N) Asst Professor HICON, CBE

2. HYPERKALEMIA Normal range - 3.6 to 5.2 millimoles per liter ( mmol /L) ECG characteristics of hyperkalemia, high blood potassium: P-waves are widened and of low amplitude due to slowing of conduction QRS complex: QRS widening fusion of QRS-T

3. loss of the ST segment Tall tented T waves The initial part of the QRS complex is often spared as purkinje fibers are less sensitive to hyperkalemia. These changes can also occur in acidosis (via the same mechanism) and during Class IC anti-arrhythmic intoxication. At concentrations > 7.5 mmol /L atrial and ventricular fibrillation can occur.

4. ECG 1

5. ECG 2

6. After Potassium Correction

7. Potassium of 9.4 mmol /L

8. Hypokalemia Hypokalemia , low blood potassium, results in: ST depression and flattening of the T wave Negative T waves A U-wave may be visible

9. Potassium level of 1.5

10. Hypercalcemia Normal R ange 8.5 to 10.5 milligrams per deciliter (mg/ dL ) Hypercalcemia , high blood calcium, speeds 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.

11. Calcium – 4.6 mmol /L

12. Hypocalcemia ECG-characteristics of hypocalcemia , low blood calcium: 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

13. Hypocalcaemia prolongs the ST segment causing QT prolongation

14. Hypermagnesaemia The normal range for blood magnesium level is 1.7 to 2.2 mg/ dL (0.85 to 1.10 mmol /L) .

15. Hypomagnesaemia ECG changes in isolated hypomagnesaemia Prolonged PR interval Prolonged QT interval

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