Electrocardiographic manifestations of hyperkalemia

Am J Emerg Med. 2000 Oct;18(6):721-9. doi: 10.1053/ajem.2000.7344.


Hyperkalemia is one of the more common acute life-threatening metabolic emergencies seen in the emergency department. Early diagnosis and empiric treatment of hyperkalemia is dependent in many cases on the emergency physician's ability to recognize the electrocardiographic manifestations of hyperkalemia. The electrocardiographic manifestations commonly include peaked T-waves, widening of the QRS-complex, and other abnormalities of altered cardiac conduction. Peaked T-waves in the precordial leads are among the most common and the most frequently recognized findings on the electrocardiogram. Other "classic" electrocardiographic findings in patients with hyperkalemia include prolongation of the PR interval, flattening or absence of the P-wave, widening of the QRS complex, and a "sine-wave" appearance at severely elevated levels. A thorough knowledge of these findings is imperative for rapid diagnosis and treatment of hyperkalemia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Electrocardiography*
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Hyperkalemia / complications
  • Hyperkalemia / diagnosis*
  • Hyperkalemia / drug therapy
  • Hyperkalemia / physiopathology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Polystyrenes / therapeutic use
  • Renal Dialysis
  • Treatment Outcome


  • Polystyrenes
  • polystyrene sulfonic acid