Question

Widen QRS and tall-tented T waves are observed in

• A. \( \text{Hyponatremia} \)
• B. \( \text{Hyperkalemia} \)
• C. \( \text{Hyperglycemia} \)
• D. \( \text{Hyperphosphatemia} \)

Hint:

Recognizing ECG changes associated with electrolyte imbalances is critical in emergency medicine. Hyperkalemia is particularly dangerous due to its potential to cause life-threatening arrhythmias. The "tall-tented T waves" are often the earliest and most specific ECG sign, followed by progressive QRS widening as potassium levels rise. This progression highlights the need for prompt recognition and treatment.

Answer 1

The Correct Option is B

Let's analyze the ECG changes associated with each option:

1. Hyponatremia: This condition refers to low sodium levels in the blood. While severe hyponatremia can affect cardiac function, typical ECG changes are non-specific and do not commonly include widened QRS complexes or tall-tented T waves.
2. Hyperkalemia: This condition refers to high potassium levels in the blood. Hyperkalemia has distinct and progressive effects on the ECG:
   • Early stages: Tall, peaked (tented), and narrow T waves (often described as "tall-tented T waves").
   • Moderate stages: Prolongation of the PR interval and widening of the QRS complex.
   • Severe stages: Further QRS widening (which can lead to a sine wave pattern), loss of P waves, and ultimately ventricular fibrillation or asystole.
   The description "widen QRS and tall-tented T waves" is characteristic of hyperkalemia.
3. Hyperglycemia: This refers to high blood glucose levels, commonly associated with diabetes. While chronic diabetes can lead to cardiovascular complications, acute hyperglycemia itself does not typically cause the specific ECG changes of widened QRS and tall-tented T waves.
4. Hyperphosphatemia: This refers to high phosphate levels in the blood. While imbalances in phosphate can occur with other electrolyte disturbances, hyperphosphatemia itself is not directly associated with the specific ECG findings of widened QRS and tall-tented T waves.

Therefore, the ECG findings of widened QRS and tall-tented T waves are characteristic of hyperkalemia.