miscellaneous abnormalities presented by martin reagon debs farr 2011

Miscellaneous Miscellaneous abnormalitiesabnormalities

Presented by Martin ReagonPresented by Martin Reagon

Debs FarrDebs Farr

20112011

Electrolyte imbalancesElectrolyte imbalances

Hyperkalaemia Hyperkalaemia

HypokalaemiaHypokalaemia

HypocalcaemiaHypocalcaemia

HypercalcaemiaHypercalcaemia

HyperKalaemiaHyperKalaemia

Peaked T wave Peaked T wave ( empire state ( empire state building!)building!)

P wave flatteningP wave flattening Prolonged PRProlonged PR QRS widensQRS widens Increase in size of U Increase in size of U

wavewave

T wave flatteningT wave flattening ST depressionST depression Prolonged QT intervalProlonged QT interval U waveU wave

Nb – Hypomagnesia Nb – Hypomagnesia can be identical!can be identical!

Hypercalcemia Hypercalcemia

Malignant tumoursMalignant tumours Excessive vitamin dExcessive vitamin d May be life threatening!!!!!!May be life threatening!!!!!! ECG- Shortens QT intervalECG- Shortens QT interval

Digitalis EffectDigitalis Effect

Digitalis toxicityDigitalis toxicity

ST depressionST depression Characteristic sag Characteristic sag

HypothermiaHypothermia

Core body temperature of Core body temperature of < < 95 degrees95 degrees Prolongation of QRSProlongation of QRS BradycardiaBradycardia Development of J wave Development of J wave

• Distinctive narrow positive wave the Osborn Distinctive narrow positive wave the Osborn wave/J wave/J deflection/camel’s humpwave/J wave/J deflection/camel’s hump

• Occurs at the junction of the QRS complex and ST Occurs at the junction of the QRS complex and ST segmentsegment

Pulmonary Embolism

S1Q3T3 pattern

a prominent S wave in lead I a Q wave and inverted T wave in lead III

sinus tachycardia T wave inversion in leads V1 - V3 Right Bundle Branch Block low amplitude deflections

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A 40 year old woman with pleuritic chest pain and breathlessness