Miscellaneous Miscellaneous abnormalitiesabnormalities

Presented by Martin ReagonPresented by Martin Reagon

Debs FarrDebs Farr

20112011

Electrolyte imbalancesElectrolyte imbalances

Hyperkalaemia Hyperkalaemia

HypokalaemiaHypokalaemia

HypocalcaemiaHypocalcaemia

HypercalcaemiaHypercalcaemia

HyperKalaemiaHyperKalaemia

Peaked T wave Peaked T wave ( empire state ( empire state building!)building!)

P wave flatteningP wave flattening Prolonged PRProlonged PR QRS widensQRS widens Increase in size of U Increase in size of U

wavewave

T wave flatteningT wave flattening ST depressionST depression Prolonged QT intervalProlonged QT interval U waveU wave

Nb – Hypomagnesia Nb – Hypomagnesia can be identical!can be identical!

Hypercalcemia Hypercalcemia

Malignant tumoursMalignant tumours Excessive vitamin dExcessive vitamin d May be life threatening!!!!!!May be life threatening!!!!!! ECG- Shortens QT intervalECG- Shortens QT interval

Digitalis EffectDigitalis Effect

Digitalis toxicityDigitalis toxicity

ST depressionST depression Characteristic sag Characteristic sag

HypothermiaHypothermia

Core body temperature of Core body temperature of < < 95 degrees95 degrees Prolongation of QRSProlongation of QRS BradycardiaBradycardia Development of J wave Development of J wave

• Distinctive narrow positive wave the Osborn Distinctive narrow positive wave the Osborn wave/J wave/J deflection/camel’s humpwave/J wave/J deflection/camel’s hump

• Occurs at the junction of the QRS complex and ST Occurs at the junction of the QRS complex and ST segmentsegment

Pulmonary Embolism

S1Q3T3 pattern

a prominent S wave in lead I a Q wave and inverted T wave in lead III

sinus tachycardia T wave inversion in leads V1 - V3 Right Bundle Branch Block low amplitude deflections

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A 40 year old woman with pleuritic chest pain and breathlessness