The P-on-U Effect
Hypokalæmia
Report:
Sinus tachycardia 135/min
Non-specific ST/T changes
Prominent U waves
Consistent with hypokalæmia
Comment:
As stated earlier, the pun is Schamrothâs174. This second example is to reward the fast learners.
The large U wave is superimposed on the P wave, obscuring the latter in all the leads except V1. In Schamrothâs case, there was also hypokalæmia-induced first and second degree AV block, making the U-P mimic T-U combination.
The serum potassium was only 2.9 mmol/L.
247. 21 year old drug addict during his unsuccessful resuscitation in Casualty. No pulses were palpable during the recording shown
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