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ECG H
- 2. Hypercalcaemia Burns E. Hypercalcaemia (April 16, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/basics/hypercalcaemia/ PowerPlugs Templates for PowerPoint Preview 2
- 3. Calcium Calcium Level (mmol/L) Normal 2,1-2,6 Mild hypercalcaemia 2,7-2,9 Moderate hypercalcaemia 3,0-3,4 Severe hypercalcaemia >3,4
- 4. Causes of hypercalcaemia PowerPlugs Templates for PowerPoint Preview 4
- 5. ECG features PowerPlugs Templates for PowerPoint Preview 5
- 6. Example (Otero & Lenihan) PowerPlugs Templates for PowerPoint Preview 6 Osborn (J) waves
- 7. Hypocalcaemia Burns E. Hypocalcaemia (April 16, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/basics/ecg-features-of-hypocalcaemia/ PowerPlugs Templates for PowerPoint Preview 7
- 8. Hypocalcaemia PowerPlugs Templates for PowerPoint Preview 8 Calcium Level (mmol/L) Normal 2,1-2,6 Mild-moderate hypocalcaemia 1,9-2,1 Severe hypocalcaemia <1,9
- 9. Causes Hypoparathyroidism Vitamin D deficiency Acute pancreatitis Hyperphosphataemia Hypomagnesaemia Diuretics (fursemide) Pseudohypoparathyroidism Congenital disorders (DiGeorge syndrome) Critical illness (sepsis) Factitious (EDTA blood tube contamination) PowerPlugs Templates for PowerPoint Preview 9
- 10. Symptoms PowerPlugs Templates for PowerPoint Preview 10
- 11. ECG QTc prolongation primarily by prolongation of the ST segment with T wave typically unchanged. Atrial fibrillation and Torsades de pointes may occur. PowerPlugs Templates for PowerPoint Preview 11
- 12. Hyperkalaemia Burns E. Hyperkalaemia (April 16, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/basics/hyperkalaemia/ PowerPlugs Templates for PowerPoint Preview 12
- 13. Hyperkalaemia PowerPlugs Templates for PowerPoint Preview 13 Potassium Level (mmol/L) Hyperkalaemia >5,5 Moderate hyperkalaemia >6,0 Severe hyperkalaemia >7,0
- 14. Potassium >5,5 mmol/L Repolarization abnormalities: • peaked T waves (the earliest sign) PowerPlugs Templates for PowerPoint Preview 14
- 15. Potassium >6,5 mmol/L Progressive paralysis of the atria: • P wave widens and flattens • PR segment lengthens • P waves eventually disappear PowerPlugs Templates for PowerPoint Preview 15 Prolongation of PR segment No P waves
- 16. Potassium >7,0 mmol/L Conduction abnormalities and bradycardia: • prolonged QRS interval with bizarre QRS morphology • high-grade AV block with slow junctional and ventricular escape rhythms • bundle branch blocks, fascicular blocks • sinus bradycardia or atrial fibrillation with slow ventricular response • sine wave appearance (pre-terminal rhythm) PowerPlugs Templates for PowerPoint Preview 16 Sine wave
- 17. Potassium >9,0 mmol/L Cardiac arrest due to: •PEA with bizarre, wide complex rhythm •Asystole •Ventricular fibrillation PowerPlugs Templates for PowerPoint Preview 17
- 18. Hypokalaemia Burns E. Hypokalaemia (April 16, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/basics/hypokalaemia/ PowerPlugs Templates for PowerPoint Preview 18
- 19. Hypokalaemia PowerPlugs Templates for PowerPoint Preview 19 Potassium Level (mmol/L) Hypokalaemia <3,5 Moderate hypokalaemia <3,0 Severe hypokalaemia <2,5
- 20. Potassium <2,7 mmol/L PowerPlugs Templates for PowerPoint Preview 20 Prominent U wave and T wave inversion
- 21. Severe hypokalaemia PowerPlugs Templates for PowerPoint Preview 21
- 22. Note! PowerPlugs Templates for PowerPoint Preview 22
- 23. Hypomagnesaemia Burns E. Hypomagnesaemia (April 16, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/basics/hypomagnesaemia/ PowerPlugs Templates for PowerPoint Preview 23
- 24. Hypomagnesaemia • Normal serum magnesium level is 0.8 – 1.0 mmol/L. •Hypomagnesaemia is <0.8 mmol/L! ECG features: • prolonged QTc • atrial and ventricular ectopy, atrial tachyarrhythmias and torsades de pointes may occur PowerPlugs Templates for PowerPoint Preview 24
- 25. Thyroid function abnormalities Lifeinthefastlane.com PowerPlugs Templates for PowerPoint Preview 25
- 26. Hyperthyroidism • Sinus tachycardia! • Atrial fibrillation with rapid ventricular response! • High left-ventricular voltage! Less frequent: • supraventricular arrhythmias: premature atrial beats, paroxysmal supraventricular tachycardia, multifocal atrial tachycardia, atrial flutter • non-specific ST and T wave changes • ventricular extrasystoles PowerPlugs Templates for PowerPoint Preview 26
- 27. Note! PowerPlugs Templates for PowerPoint Preview 27
- 28. Hypothyroidism Severe hypothyroidism (myxoedema) causes a triad of: • Bradycardia! • Low QRS voltage! • Widespread T-wave inversions usually without ST deviation! Other ECG changes are: • QT prolongation • first degree AV block • interventricular conduction delay PowerPlugs Templates for PowerPoint Preview 28
- 29. Myxoedema triad PowerPlugs Templates for PowerPoint Preview 29 Bradycardia of about 30/min! Low QRS voltage! T wave inversion without ST-segment deviation in precordial leads!
- 30. Hypothermia Burns E. Hypothermia (April 4, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/basics/hypothermia/ PowerPlugs Templates for PowerPoint Preview 30
- 31. Hypothermia PowerPlugs Templates for PowerPoint Preview 31
- 32. Literature PowerPlugs Templates for PowerPoint Preview 32