Electrocardiogram with measurement of Serum Potassium :Better Clinical Assessment

Potassiumplays a critical role in muscle contraction, maintenance of fluid and electrolyte balance, nerve conduction, cardiac rhythm. European Resuscitation Council (ERC) Guidelines defines hyperkalemia with a serum potassium(K) level of ≥ 5.5 mmol/L. Hyperkalemia is anelectrolyte disorder which is potentially life-threatening with incidence ranging between 1.1 and 10% in hospitalized patients. The present study was conducted in adult patients to identify the various factors associated with hyperkalemia and proportion of hyperkalemic patients with Electrocardiogram (ECG) changes. Material and Method: We conducted across sectional study at our tertiary care hospital with 140 adult patients with incidentally detected hyperkalemia ,visiting medicine out-patients(32) and in-patients department(108).ECG recordingsand clinical, and biochemical parameters were performed for them along withassessment of records to identify associated disorders. Results: Hyperkalemia was associated with chronic kidney disease (51.4%), Acute kidney injury (15%),drugs related(29.3%)andothers with tumor necrosis, Systemic Lupus Erythematousetc.(4.3%).Hyperkalemia was noted as Mild(77.9%),Moderate (15%) ,and Severe (7.1%) patients. Abnormal ECG changes were seen in sixty-eight patients, (48.6%) with tall T wave in (39.7%), tall T wave along with prolonged PR interval in (20.6%), prolonged PR interval in (5.9%), and pseudo-ST elevation, sinus bradycardia in (16.4%) patients and normal ECG findings in 72 patients (51.42%). Conclusion: Hyperkalemia was found in out-patients and in-patients with chronic kidney diseases, Acute Kidney diseases, drugs related and may present with or without associated ECG changes. Hyperkalemia needs to be investigated by direct serum potassium measurement and treated aggressively irrespective to normal ECG recordings.