Gitelmanâs Syndrome: Hypokalæmia
Report:
Sinus rhythm 85/min
Right axis deviation +140o
Right bundle branch block
Large TU waves c/w hypokalæmia
Comment:
This is, almost, a P-on-U phenomenon (no pun intended), as Schamroth put it11. The diagnosis can only be made, as reported, in a context of known hypokalæmia (1.4 mEq/L at the time of the recording). Otherwise, long QT interval or âcerebralâ TU waves are a possibility. There is no clear separation of T and U waves in any lead. Indeed, the QTc may itself be prolonged here, because of the associated hypomagnesæmia.
A later trace, with potassium of 2.0 mEq/L, is shown below. The U waves are now separate, but not particularly striking. ECG is a poor tool here and there is no substitute for actual electrolyte measurements.
Gitelmanâs is a variant of Bartterâs syndrome12.
7a. 8. 71 year old lady with severe aortic stenosis and GI bleeding, presumptive Heydeâs syndrome
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.