![]() ![]() ![]() When we superimpose these two T waves (C) you can see why people say that the hyperkalemic T wave appears to be pinched (black arrows) in the middle compared to the normal variant. The male variant T wave is broad based (D, black line) and does not rise to a point but rather to a curve at its apex (blue curve). These features are said to result in a 'tented' appearance. In the case of hyperkalemia, the tall T wave has a narrow base (C, black line) and rises rapidly to a point (C, red arrow). If we use the computer to superimpose the 'normal variant' tall T wave (red T wave, (C)) on those associated with hyperkalemia you can appreciate the difference. However, you can see that they differ markedly in morphology (below). In reality, ‘tall’ T waves are quite common on the ECG of normal individuals, particularly young men ('normal variant' in B and see our videos on avoiding error in ECG interpretation on ). In text books, we are told that in a given lead, the T wave should be no more than half the amplitude of the preceding R wave. In the presence of hyperkalemia, the T wave on the ECG/EKG rises in amplitude (A, below). There are five ECG/EKG changes/groups of changes associated with hyperkalemia which you must be able to recognise. Recognition of the ECG/EKG changes of hyperkalemia can save lives. It produces predictable changes on the ECG/EKG. ![]() Hyperkalemia (serum K + > 5.5 mmol/l) is a life-threatening medical emergency. ![]()
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