Peaked T waves

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Peaked T waves refers to the pointed, tall, peaked shape of T waves on the EKG in the setting of certain abnormalities such as hyperkalemia.

Differential Diagnosis

  • Differential diagnosis of this EKG change includes the T wave changes of bradycardia or stroke.
  • Prominent U waves and QTc prolongation are more consistent with stroke than hyperkalemia.

Diagnosis

  • Earliest sign of hyperkalemia
  • Occurs with K > 5.5 meq/li

Electrocardiographic Examples

Shown below is the progression of T wave changes in hyperkalemia: Peaked T waves

Shown below is an EKG showing peaked T waves in the lateral leads: Peaked T waves

Shown below is an EKG showing symmetric, narrow, peaked T waves in the lateral leads: Tall, symmetric, narrow based T waves in a hyperkalemic patient.

References