{"id":770,"date":"2018-08-01T00:01:05","date_gmt":"2018-08-01T00:01:05","guid":{"rendered":"http:\/\/torreyekg.com\/?p=770"},"modified":"2018-08-24T14:02:41","modified_gmt":"2018-08-24T14:02:41","slug":"ekg-of-the-week-56","status":"publish","type":"post","link":"http:\/\/torreyekg.com\/index.php\/2018\/08\/01\/ekg-of-the-week-56\/","title":{"rendered":"EKG of the Week #56"},"content":{"rendered":"

\"\"<\/a>
\n26-year-old woman presents with generalized weakness.
\nPMH: SLE, ESRD with hemodialysis; she denies missing dialysis <\/p>\n

Answer & Explanation<\/div>

\nThis bradycardic rhythm is wide-complex and regular at 22\/minute. There are no discernible P waves. Without further information this rhythm is best described as a slow junctional rhythm.\n

However, we do have more information. This young woman has SLE with renal failure requiring dialysis. Even if she has not missed a dialysis session, one must assume this bradycardic wide-complex rhythm is due to hyperkalemia.<\/p>\n

Hyperkalemia has several predictable effects on the EKG. The P-wave, QRS-complex, and T-wave are all targets of this \u201cpoison\u201d that effects normal depolarization and repolarization. These effects occur in a predictable sequence. The first sign seen is increased amplitude of the T waves \u2013 a peaked, narrow-based T wave. As the level of potassium continues to rise, the next changes are prolongation of the QRS complex and then diminution of the P wave. With further QRS prolongation, the EKG complex begins to resemble the pre-terminal sin wave of critically severe hyperkalemia.
\n\"\"<\/a>
\nAfter treatment with Ca++ gluconate
\n\"\"<\/a>
\n<\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

26-year-old woman presents with generalized weakness. PMH: SLE, ESRD with hemodialysis; she denies missing dialysis<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-770","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/770","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=770"}],"version-history":[{"count":2,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/770\/revisions"}],"predecessor-version":[{"id":775,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/770\/revisions\/775"}],"wp:attachment":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=770"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=770"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=770"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}