Background Tall, symmetrically peaked T waves commonly appear throughout the precordium (V1 to V6) as serum K+ rises above 5.5 mmol/L. During routine ECG analysis, we found such T waves, but they were confined to V1-3. We then ascertained these tracings belonged to a group of patients with either end-stage renal disease or who had received a renal transplant. We therefore sought to determine whether this localized T wave abnormality was a marker of hyperkalemia.
Methods Retrospective analysis of clinical and laboratory data, including serum electrolytes, blood urea nitrogen and creatinine, together with echocardiogram in 19 patients (6F; 13M), ranging in age from 30 to 67 years, whose ECG revealed this localized T wave abnormality during routine interpretation. Nine patients had end-stage renal disease and 8 had received renal and 2 renal and pancreas transplants within 11 months to 9 years.
Results Of the 19 patients with the localized T wave abnormality and renal involvement, 6 (31%) had hyperkalemia. One of these patients had end-stage renal disease and a serum K+ of 7.6 mmol/L while 5 of 10 patients with renal transplants had a serum K+ > 5.5 mmol/L and in three of these persons serum K+ was > 6.8 mmol/L. Evidence of LVH was found on ECG and/or echocardiogram in 15 of these 19 patients.
Conclusions A localized T wave abnormality, confined to V1-V3 and expressed as tall symmetrically peaked T waves, can occur in patients with end-stage renal disease or renal transplantation who have hyperkalemia. In other such persons this localized T wave abnormality may be a normal variant.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.