Hyperkalemia - ECG Diagnosis

4/17/02 (House)

Question: How does one differentiate hyperkalemia from left bundle branch block using electrocardiography?

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Unique Identifier:3559133

Authors: Dittrich KL. Walls RM.

Title: Hyperkalemia: ECG manifestations and clinical considerations.

Source: Journal of Emergency Medicine. 4(6):449-55, 1986.

Abstract: Hyperkalemia is a common cause of electrolyte induced cardiac conduction disturbance. A well-defined series of changes at the cellular level leads to characteristic evolutionary changes in the surface electrocardiogram. Initial high T waves and shortened intervals give way to prolongation of conduction and lethal dysrhythmias as the serum potassium level rises. The patterns of electrocardiographic changes associated with hyperkalemia are reviewed and an outline of appropriate therapeutic interventions. CAS Registry/EC Number 7440-09-7 (Potassium).

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Unique Identifier:1119378

Authors: Bashour T. Hsu I. Gorfinkel HJ. Wickramesekaran R. Rios JC.

Title: Atrioventricular and intraventricular conduction in hyperkalemia.

Source: American Journal of Cardiology. 35(2):199-203, 1975 Feb.

Abstract: Twelve patients exhibited electrocardiographic evidence of fascicular block during hyperkalemia. Isolated left posterior hemiblock occurred in four, isolated left anterior hemiblock in two, right bundle branch block with left anterior hemiblock in two, right bundle branch block with left posterior hemiblock in one, left bundle branch block with abnormal left axis deviation in two and advanced atrioventricular block in one. In all seven patients with sinus rhythm the P-R interval shortened after correction of hyperkalemia. Electrophysiologic studies using His bundle recording and atrial pacing in one patient revealed intraatrial conduction delay and marked prolongation of conduction time in the His-Purkinje system. It is concluded that conduction defects in the specialized intraventricular conduction system are common in hyperkalemia and result in electrocardiographic patterns of fascicular block. CAS Registry/EC Number 7440-09-7 (Potassium).

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Unique Identifier:4604546

Authors: Ettinger PO. Regan TJ. Oldewurtel HA.

Title: Hyperkalemia, cardiac conduction, and the electrocardiogram: a review. [Review] [78 refs]

Source: American Heart Journal. 88(3):360-71, 1974 Sep.