ABC of clinical electrocardiography: Conditions not primarily affecting the heart

doi:10.1136/bmj.324.7349.1320

BMJ 2002;324:1320-1323 ( 1 June )

Clinical review

ABC of clinical electrocardiography

Conditions not primarily affecting the heart

Corey Slovis, Richard Jenkins.

The first 150 words of the full text of this article appear below.

To function correctly, individual myocardial cells rely on normal concentrations of biochemical parameters such as electrolytes,oxygen, hydrogen, glucose, and thyroid hormones, as well as anormal body temperature. Abnormalities of these and other factorsaffect the electrical activity of each myocardial cell and thusthe surface electrocardiogram. Characteristic electrocardiographicchanges may provide useful diagnostic clues to the presence ofmetabolic abnormalities, the prompt recognition of which can belife saving.
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Hyperkalaemia

Increases in total body potassium may have dramatic effects on the electrocardiogram. The most common changes associated withhyperkalaemia are tall, peaked T waves, reduced amplitude andeventually loss of the P wave, and marked widening of the QRScomplex.
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The earliest changes associated with hyperkalaemia are tall T waves, best seen in leads II, III, and V2 to V4. Tall T wavesare usually seen when the potassium concentration rises above5.5-6.5 mmol/l. However, only about one in five . . . [Full text of this article]

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