Hyperkalæmia: Sine Curve Tachycardia
Report:
First-second strips:
Broad-complex rhythms of uncertain origin
Third-fourth strips:
‘Sine curve’ tachycardia
Fifth-sixth strips:
Broad-complex tachycardia
Movement, probably CPR, artefact
Seventh strip (30 minutes since the top strip):
Sinus tachycardia
Intraventricular conduction defect
Eight (bottom) strip – K+ 4.6mEq/L:
Sinus tachycardia
VEBs
Comment:
The bottom strip was obtained four hours after the onset of resuscitation.
This is one of the best examples of the ‘sine curve’ morphology produced by merging of T waves with broad QRS complexes in hyperkalæmia. It looks like a sluggish (fat and relatively slow) variety of ventricular flutter.
The patient died, eventually, after a week of regular hæmodialysis, from sepsis. Patients no longer die from acute renal failure, although mortality is still around 50%; they die with it. The same can be said for ARDS.
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