Hypokalæmia

Report:

Sinus rhythm.

Borderline left axis deviation -30o.

Prominent repolarisation changes suggestive of hypokalæmia.

Comment:

The patient had severe metabolic acidosis and marked, paralysing hypokalæmia (K 1.7 mEq/L) No cause was found during her 4-day long stay in the ICU, but, some weeks later, renal tubular acidosis due to Sjogren’s syndrome was diagnosed.

The U waves are so large that they may be mistaken for T waves. The U waves became more discrete in the tracing below (Fig 264a), at K 2.0 mEq/L. They stand up for themselves quite well in V2-3. Eventually (not shown) her ECG became normal

264a. 265. 60 year old manic-depressive woman with gross agitation who became stuporose on lithium therapy over two days.

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