A hospitalized patient with known renal failure develops progressive lower extremity muscle weakness. The EKG is shown above.Challenge: What is the abnormality seen and what is its significance?
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The tall peaked and symmetric T waves (best seen in V3, V4) suggest hyperkalemia. In hyperkalemia, the first change is peaked T waves and shortened QT intervals, followed by lengthening of the PR and QRS, loss of P waves, and progression into a sine wave.
Sources: UpToDate; www.emedu.org.
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