Question

A man on diuretics presents with weakness. An ECG was done which showed flat T waves and prominent U waves. What is the most likely diagnosis?

• A. Hypokalaemia
• B. Hyperkalaemia
• C. Hypomagnesemia
• D. Hypernatremia

Answer 1

The Correct Option is D

The question revolves around interpreting ECG changes associated with electrolyte imbalances due to diuretic use. The patient presents with weakness, and the ECG shows flat T waves and prominent U waves. These features need to be correlated with the given options to determine the most likely diagnosis.

First, consider the impacts of each electrolyte imbalance:

1. Hypokalaemia: Low potassium levels frequently result in ECG changes, including flat T waves, prominent U waves, ST segment depression, and a prolonged QT interval. The presence of these ECG changes in the patient strongly supports this diagnosis, considering the use of diuretics can cause hypokalemia by increasing the excretion of potassium.

2. Hyperkalaemia: High potassium levels typically cause peaked T waves, flattened P waves, prolonged PR interval, and widening of the QRS complex, which are not observed in this case.

3. Hypomagnesemia: This can also cause ECG changes like prolonged QT interval and torsades de pointes but does not typically present with flat T waves and prominent U waves.

4. Hypernatremia: High sodium levels do not specifically cause the ECG changes mentioned and usually lead to neurological symptoms rather than cardiac ones.

Given these interpretations, Hypokalaemia is the most likely diagnosis given the patient's presentation and specific ECG findings.