ECG findings

  QT interval is prolonged due to prolongation of the ST segment .

  It is generally accepted that hypocalcemia does not affect T wave.

  The sensitivity and specificity of the ECG findings of hypocalcemia are not high.

  Failure to observe anticipated ECG findings does not necessarily rule out the possibility of hypocalcemia.







ECG 1a. The above ECG belongs to a patient with serum levels of calcium 6.5 mg/dL, potassium 5.1 mmol/L and creatinine
4.1 mg/dL.

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ECG 1b. The ECG of the same patient was recorded at a calibration of 20mm/mV to see the details more clearly.

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ECG 2a. The above ECG belongs to a chronic renal failure patient who refused hemodialysis for the last 10 days. When the
above ECG was recorded, his serum potassium was level 9mmol/L and serum calcium level was 7.8 mg/dL. His ECG shows
evidence of hyperkalemia and hypocalcemia:
Increased T wave amplitude , decreased P wave amplitude and widening of
the QRS complex suggest hyperkalemia.
Prolongation of the ST segment resulting in increased QT interval suggests
hypocalcemia.

Dr. Isik Sonmez has donated the above ECG to our website.

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EKG 2b. The above ECG belongs to the same patient and was recorded after hemodialysis. This time, his serum potassium
level was 4.6 mmol/L and his serum calcium level was 10.5 mg/dL. After normalization of the serum potassium level
T wave
amplitude decreased
, P wave amplitude increased and QRS widening disappeared. Normalization of the serum calcium level
resulted in the
disappearance of ST segment prolongation .

Dr. Isik Sonmez has donated the above ECG to our website.

Click here for a more detailed ECG