This
is the 12L ECG of a 70 yo patient with h/o of HTN, hyperlipidemia DM, CHF and
ESRD c/o vomiting.
Figure 1
The
12L showed a regular wide QRS rhythm at rate of about 94 bpm, RBBB morphology
and left anterior fascicular block pattern. P waves are best seen in long lead II. The QRS duration is about 200 ms
which is very wide. Tall and tented T waves can be appreciated in V3. This ECG is
highly suggestive of an ECG pattern of a patient with hyperkalemia.
Potassium
came back at 6.5. Calcium gluconate, glucose/insulin and sodium bicarbonate
were given and was dialyzed.
Interpretation: Sinus rhythm, right bundle branch block, left anterior fascicular block, hyperkalemia.
#632
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