Uncommon ECG Changes as A Manifestation of Hyperkalemia

      A 55-year-old woman with a past medical history significant for end-stage renal disease on hemodialysis, type 2 diabetes mellitus, and coronary artery disease status post 4-vessel coronary artery bypass grafting 6 years earlier, presented to the Emergency Department after feeling dizzy, lethargic, and weak.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Parham WA
        • Mehdirad AA
        • Biermann KM
        • Fredman CS
        Hyperkalemia revisited.
        Tex Heart Inst J. 2006; 33: 40-47
        • Dittrich KL
        • Walls RM
        Hyperkalemia: ECG manifestations and clinical considerations.
        J Emerg Med. 1986; 4: 449-455
        • Vuckovic K
        • Richlin D
        Bradycardia induced by hyperkalemia.
        AAOHN J. 2004; 52: 186-187
        • Noble K
        • Isles C
        Hyperkalaemia causing profound bradycardia.
        Heart. 2006; 92: 1063
        • Szerlip HM
        • Weiss J
        • Singer I
        Profound hyperkalemia without electrocardiographic manifestations.
        Am J Kidney Dis. 1986; 7: 461-465
        • Martinez-Vea A
        • Bardají A
        • Garcia C
        • Oliver JA
        Severe hyperkalemia with minimal electrocardiographic manifestations: a report of seven cases.
        J Electrocardiol. 1999; 32: 45-49
        • Bianchi S
        • Aucella F
        • De Nicola L
        • Genovesi S
        • Paoletti E
        • Regolisti G
        Management of hyperkalemia in patients with kidney disease: a position paper endorsed by the Italian Society of Nephrology.
        J Nephrol. 2019; 32: 499-516
        • Slade TJ
        • Grover J
        • Benger J
        Atropine-resistant bradycardia due to hyperkalaemia.
        Emerg Med J. 2008; 25: 611-612
        • Senthilkumaran S
        • David SS
        • Manikam R
        • Thirumalaikolundusubramanian P
        Atropine resistant bradycardia and hyperkalemia: our experiences.
        Am J Emerg Med. 2013; 31: 1415
        • Lu HT
        • Kam J
        • Nordin RB
        • et al.
        Beta-blocker use and risk of symptomatic bradyarrhythmias: a hospital-based case-control study.
        J Geriatr Cardiol. 2016; 13: 749-759
        • Tarail R
        Relation of abnormalities in concentration of serum potassium to electrocardiographic disturbances.
        Am J Med. 1948; 5: 828-837