Nikelekam T-waves
Results:
Hypokalemia
Key Points Hypokalemia slows ventricular repolarization and alters the T–U complex before it triggers arrhythmias. Progressive pattern: T-wave flattening → prominent U waves → T–U fusion with apparent QT prolongation;…
Hypokalemia Emergencies
Key Points Severe hypokalemia can produce dramatic ECG changes that may be mistaken for acute coronary syndromes. It can also precipitate life-threatening arrhythmias, including torsades de pointes and ventricular tachyarrhythmias…
Interesting Cases from UMMC (2024 – Part II/III)
A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:
Reverse Wellens Waves: not all biphasic T waves are indicative of ACS!
A 25-year-old woman presents to the emergency department with lightheadedness and palpitations for 1 week. Her symptoms worsened today with a near-syncopal episode. She is thin/frail and dehydrated in appearance….
Differential Diagnoses: a triad of long QT interval, PVCs, & ST segment depression
A 56-year-old woman presents to a busy ED dehydrated with acute gastroenteritis. She is placed in a hallway bed and treated with IV fluids and ondansetron. On reassessment the patient…
Generalized weakness with biphasic T waves in the anterior leads
A young man presents to the ED with generalized weakness. The following ECG is obtained:
Differential Diagnoses: long QTc interval
HPI: 32-year-old female with PMHx of hyperthyroidism (on carbimazole) presents with jaundice and intermittent palpitations. She has mild RUQ abdominal pain, but is otherwise well. Vitals: HR~100, BP-130/70, RR-18, afebrile. Exam:…
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