POTASSIUM-HYPERKALEMIA MANIFESTATIONS

SUMMARY

1. Symptoms manifest when the rise is acute. Problems usually occur when K⁺ ~ 6 mEq/L. Toxic effects may be seen at lesser levels with rapid rise in K (unlikely if K < 5.0).

2. Presentation can include significant weakness or paralysis, conduction abnormalities or arrhythmias.

Sequence of ECG changes:
3. Peaked T wave and short QT interval

4. Progressive lengthening of PR and QRS intervals

5. Loss of P wave & QRS widening into sine wave

6. Ventricular fibrillation or cardiac standstill.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].