From Glancy DL. J La State Med Soc 2007; 159:5-7

Elias Hanna, MD, Cardiology

Hypokalemia:

Flat T with K~3ST depression with prominent T

(actually U) and prolonged QT

when K<2.5-3

• Hypokalemia: -T progressively flattens -U wave more and more prominent (looks like

T) -ST-segment more and more depressed

Large U wave simulates and hides T wave with severe hypokalemia, the ST-T pattern may mimick: ST-segment depression with a flat or upright wide “T” wave (actually U) and a prolonged “QT” interval (actually QTU)

On the other hand, the pattern of T inversion is not seen with hypokalemia:

ST depressionischemia

ST

elevation

ischemia

Hanna EB, Glancy DL. CCJM June 2011