Hypokalæmia, pre-VF
Report:
Sinus rhythm
Right atrial abnormality
Poor R wave progression
Probable left ventricular hypertrophy
Nonspecific ST/T changes
Prolonged QT interval ? large U waves
Somatic tremor
Comment:
Potassium was 2.0 mEq/L and the pH 7.66. Most patients with profound hypokalæmia that come to ICU never have a single VEB. This one went into VF, perhaps due to marked alkalosis. It is a moot point whether one can go into VF ab initio, without a “causal” VEB or even an “introductory” VT. This point is more semantic than electrophysiological.
Below is a later trace (Fig 294a), showing clearer separation of the U waves from the preceding T waves.
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