Renal tubular acidosis electrocardiogram: Difference between revisions
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{{CMG}} ; {{AE}} {{ADG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Oveview== | ==Oveview== | ||
Electrocardiogram findings associated with renal tubular acidosis include changes due to potassium levels. [[Peaked T waves]] are the earliest sign of hyperkalemia. where as hypokalemia presents with S[[ST segment depression|T segment depression]], decreased [[T wave]] amplitude, and prominent [[U waves]]. | |||
==Electrocardiogram== | ==Electrocardiogram== | ||
Electrocardiogram changes in renal tubular acidosis is associated with potassium changes. | |||
==== Hyperkalemia ==== | |||
EKG findings of hyperkalemia associated with renal tubular acidosis include: | |||
* Peaked T Waves | |||
**[[Peaked T waves]] are the earliest sign of hyperkalemia. | |||
* Interventricular Conduction Delay | |||
**It is observed when K > 6.5 meq/L | |||
**Interventricular conduction delay is reflected by [[Wide QRS|QRS widening]] that are inconsistent with [[LBBB]] or [[RBBB]]. | |||
* Loss of P Waves<ref name="pmid16572868">{{cite journal| author=Parham WA, Mehdirad AA, Biermann KM, Fredman CS| title=Hyperkalemia revisited. | journal=Tex Heart Inst J | year= 2006 | volume= 33 | issue= 1 | pages= 40-7 | pmid=16572868 | doi= | pmc=PMC1413606 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16572868 }}</ref><ref name="pmid22571204">{{cite journal| author=Petrov DB| title=Images in clinical medicine. An electrocardiographic sine wave in hyperkalemia. | journal=N Engl J Med | year= 2012 | volume= 366 | issue= 19 | pages= 1824 | pmid=22571204 | doi=10.1056/NEJMicm1113009 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22571204 }}</ref> | |||
* Sinus Arrest with Accelerated Junctional Rhythm<ref name="pmid16792034">{{cite journal |author=Bonvini RF, Hendiri T, Anwar A |title=Sinus arrest and moderate hyperkalemia |journal=[[Annales De Cardiologie Et D'angéiologie]] |volume=55 |issue=3 |pages=161–3 |year=2006 |month=June |pmid=16792034 |doi= |url= |issn=}}</ref><ref name="pmid11207412">{{cite journal| author=Mehta NJ, Chhabra VK, Khan IA| title=Sinus arrest or sinoventricular conduction in mild hyperkalemia. | journal=J Emerg Med | year= 2001 | volume= 20 | issue= 2 | pages= 163-4 | pmid=11207412 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11207412 }}</ref><ref name="pmid22571204" /> | |||
* Sine Wave Pattern<ref name="pmid16572868" /><ref name="pmid22571204" /> | |||
* Ventricular fibrillation | |||
==== Hypokalemia ==== | |||
EKG findings of hypokalemia associated with renal tubular acidosis include: | |||
* [[ST segment depression]], decreased [[T wave]] amplitude, and prominent [[U waves]] | |||
* [[Prolongation of the QRS]] duration | |||
* Increase in the amplitude and duration of the [[P-wave]] | |||
* [[Cardiac arrhythmias]] and [[AV block]] | |||
* Contrary to popular belief there is not prolongation of the QTc, this is artifactually prolonged due to the U wave. In some cases there is fusion of the T and U waves making interpretation impossible. | |||
* Ventricular ectopy | |||
** [[Premature ventricular complex]] | |||
** [[Ventricular tachycardia]] | |||
** [[Ventricular fibrillation]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 23:40, 31 May 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Oveview
Electrocardiogram findings associated with renal tubular acidosis include changes due to potassium levels. Peaked T waves are the earliest sign of hyperkalemia. where as hypokalemia presents with ST segment depression, decreased T wave amplitude, and prominent U waves.
Electrocardiogram
Electrocardiogram changes in renal tubular acidosis is associated with potassium changes.
Hyperkalemia
EKG findings of hyperkalemia associated with renal tubular acidosis include:
- Peaked T Waves
- Peaked T waves are the earliest sign of hyperkalemia.
- Interventricular Conduction Delay
- It is observed when K > 6.5 meq/L
- Interventricular conduction delay is reflected by QRS widening that are inconsistent with LBBB or RBBB.
- Ventricular fibrillation
Hypokalemia
EKG findings of hypokalemia associated with renal tubular acidosis include:
- ST segment depression, decreased T wave amplitude, and prominent U waves
- Prolongation of the QRS duration
- Increase in the amplitude and duration of the P-wave
- Cardiac arrhythmias and AV block
- Contrary to popular belief there is not prolongation of the QTc, this is artifactually prolonged due to the U wave. In some cases there is fusion of the T and U waves making interpretation impossible.
- Ventricular ectopy
References
- ↑ 1.0 1.1 Parham WA, Mehdirad AA, Biermann KM, Fredman CS (2006). "Hyperkalemia revisited". Tex Heart Inst J. 33 (1): 40–7. PMC 1413606. PMID 16572868.
- ↑ 2.0 2.1 2.2 Petrov DB (2012). "Images in clinical medicine. An electrocardiographic sine wave in hyperkalemia". N Engl J Med. 366 (19): 1824. doi:10.1056/NEJMicm1113009. PMID 22571204.
- ↑ Bonvini RF, Hendiri T, Anwar A (2006). "Sinus arrest and moderate hyperkalemia". Annales De Cardiologie Et D'angéiologie. 55 (3): 161–3. PMID 16792034. Unknown parameter
|month=ignored (help) - ↑ Mehta NJ, Chhabra VK, Khan IA (2001). "Sinus arrest or sinoventricular conduction in mild hyperkalemia". J Emerg Med. 20 (2): 163–4. PMID 11207412.