{"id":1623,"date":"2024-01-14T08:48:08","date_gmt":"2024-01-14T15:48:08","guid":{"rendered":"https:\/\/blog.medcram.com\/?p=1623"},"modified":"2024-01-28T08:57:08","modified_gmt":"2024-01-28T15:57:08","slug":"hyperkalemia-peaked-t-waves-and-ecg-recognition","status":"publish","type":"post","link":"https:\/\/blog.medcram.com\/cme-courses\/hyperkalemia-peaked-t-waves-and-ecg-recognition\/","title":{"rendered":"Hyperkalemia-Peaked T waves and ECG Recognition"},"content":{"rendered":"<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/yTitSR5r0Uo?si=Hep408V_nYYZ-E_q\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><span style=\"font-weight: 400;\">In this video from Medcram, Dr. Seheult discusses recognition of hyperkalemia findings on ECG. He discusses the specific case of a patient with COVID-19 who came in with rhabdomyolysis. <\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What is rhabdomyolysis?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">This is muscle breakdown which leads to the release of the contents of multiple cells in the body and can lead to a condition of hyperkalemia or high potassium. Hyperkalemia can be very deadly. It can lead to cardiac arrhythmias and cardiac arrest. Potassium in of itself is one of the most controlled electrolytes within the body. Dr. Seheult reviews a <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9611306\/#:~:text=Rhabdomyolysis%20is%20a%20known%20complication,(LDH)%20%5B3%5D\">\u00a0case report <\/a>of rhabdomyolysis occurring after COVID-19. Rhabdomyolysis itself can occur after viral infections but can also occur in traumatic injuries such as crush injuries. It can even occur in prisons who have had a strenuous workout and even seen for example in marathon running. One thing people may notice is that their urine has turned a tea-color which is a potential signal that muscle is being broken down and being released into the urine.\u00a0 This<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9611306\/#:~:text=Rhabdomyolysis%20is%20a%20known%20complication,(LDH)%20%5B3%5D\">\u00a0case report <\/a>that Dr. Seheult reviews states in its discussion that rhabdomyolysis is a known complication of viral and bacterial infections. It is characterized by the breakdown of skeletal muscle leading to the release of muscular components into the bloodstream including myoglobin, creatinine kinase, and lactate dehydrogenase. It is important to remember that cells are very rich in potassium and when these cells break down that\u2019s going to lead to a significant release of potassium into the bloodstream which may be difficult for the body to regulate. <\/span><\/p>\n<h2><span style=\"font-weight: 400;\">ECG findings of hyperkalemia<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If you were to look at an ECG of somebody with severe hyperkalemia, you would see a lack of P waves followed by very peaked T waves. In some cases the peaked T waves are so tall that they may actually be taller than the QRS complex itself which should never be the case.\u00a0 <\/span><span style=\"font-weight: 400;\">\u00a0Patients may come in with nonspecific symptoms with hyperkalemia. You will need a definitive test which is a basic metabolic panel also known as a chem-7. <\/span><a href=\"https:\/\/www.medcram.com\/courses\/bmp-chem-7-results-explained-clearly\"><span style=\"font-weight: 400;\">MedCram<\/span><\/a><span style=\"font-weight: 400;\"> has a course on this for those who are interested in a more in depth dive into the basic metabolic panel.\u00a0 A normal potassium level should range from 3.5-5 meq\/L; however, if you are starting to see peaked T waves, the potassium levels are generally at 6 meq\/L or above. The EKG he goes over in this case is also showing some bradycardia. He explains how to calculate the heart rate based on the EKG.\u00a0 Medcram also has an extensive course on <\/span><a href=\"https:\/\/www.medcram.com\/courses\/ekg-ecg-interpretation-explained-clearly\"><span style=\"font-weight: 400;\">ECG interpretation<\/span><\/a> <span style=\"font-weight: 400;\">as well.<\/span><\/p>\n<h2>Treatment of hyperkalemia<\/h2>\n<p><span style=\"font-weight: 400;\">Depending on the level of the hyperkalemia, the treatment options range from immediate stabilization to those that will take several hours to work. For patients that have elevated T waves and appear to be going into possible cardiac arrest you can give albuterol, bicarbonate, insulin and glucose, furosemide, and even potassium binders that work in the gut. However, none of these are going to work within a few minutes and for a patient with impending cardiac arrest you need something that is going to stabilize the cardiac membranes immediately which is calcium.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It should be noted that you don\u2019t necessarily need a 12 lead ECG to notice hyperkalemia changes. Smart watches use lead I from an ECG now have the ability to monitor your pulse. An ECG is basically a photograph of how electricity is moving throughout your heart. Medcram has <\/span><a href=\"https:\/\/www.youtube.com\/watch?v=0HxOWCw4hEU\"><span style=\"font-weight: 400;\">video on smart watches<\/span><\/a><span style=\"font-weight: 400;\"> and ECG.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The key to hyperkalemia, as in any disease, is early recognition and treatment.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">LINKS \/ REFERENCES:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Rhabdomyolysis after COVID-19 Infection: A Case Report and Review of the Literature (Viruses) |<\/span><a href=\"https:\/\/www.youtube.com\/redirect?event=video_description&amp;redir_token=QUFFLUhqa3VQbzFESU1vY0Z3TWtOWjNDdzBYaTlveUFqZ3xBQ3Jtc0tudHB0Mkh5d0wyaUpzaXZZbmdTRXNaaHQzOWwtQVl5LVFRemV5YmVTUTl6NHNTREt1U1N5VUJIZmpsMklhY0t2VDU4WUNWVVREeDNxcnFvWlFNMjJ5UTZRMlpVeXM0N3FMOXJDOWRPSmlHdFE2anZVYw&amp;q=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9611306%2F%23%3A%7E%3Atext%3DRhabdomyolysis%2520is%2520a%2520known%2520complication%2C%28LDH%29%2520%255B3%255D&amp;v=yTitSR5r0Uo\"> <span style=\"font-weight: 400;\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/arti&#8230;<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p>&nbsp;<\/p>\n<!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<p>In this video from Medcram, Dr. Seheult discusses recognition of hyperkalemia findings on ECG. He discusses the specific case of a patient with COVID-19 who came in with rhabdomyolysis. What is rhabdomyolysis? This is muscle breakdown which leads to the release of the contents of multiple cells in the body and can lead to a&hellip;<!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n","protected":false},"author":8,"featured_media":1621,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10,17],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Hyperkalemia-Peaked T waves and ECG Recognition - Medcram Blog<\/title>\n<meta name=\"description\" content=\"In this video from Medcram, Dr. Seheult discusses recognition of hyperkalemia findings on ECG.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blog.medcram.com\/cme-courses\/hyperkalemia-peaked-t-waves-and-ecg-recognition\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hyperkalemia-Peaked T waves and ECG Recognition - 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