Hyperosmolar hyperglycemic state electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Patients suffering from the hyperosmolar hyperglycemic state may exhibit electrocardiographic (EKG) changes characteristic of toxic hyperkalemia. Common abnormalities observed on EKG include tall peaking T waves, prolonged QT interval, and widening of QRS complex.

Electrocardiogram

Nonspecific ECG changes including sinus tachycardia, st segment changes, and changes in heart rate variability; which can be seen in long-standing diabetes mellitus may also be present during an episode of hyperosmolar hyperglycemic state.
ECG findings associated with hyperkalemia seen during hyperosmolar hyperglycemic state include:^[1]^[2]^[3]^[4]
- Tall peaking T waves
- Prolonged QT interval
- Widening of QRS complex
- Prolongation of the ST interval

References

↑ “Hypocalcemia: Diagnosis and Treatment – Endotext – NCBI Bookshelf”.
↑ “ST-Segment Elevation Resulting From Hyperkalemia | Circulation”.
↑ Süfke S, Djonlagić H, Kibbel T (2010). “[Impairment of cardiac autonomic nervous system and incidence of arrhythmias in severe hyperglycemia]”. Med. Klin. (Munich) (in German). 105 (12): 858–70. doi:10.1007/s00063-010-1150-3. PMID 21240584.
↑ Petrov D, Petrov M (2008). “Widening of the QRS complex due to severe hyperkalemia as an acute complication of diabetic ketoacidosis”. J Emerg Med. 34 (4): 459–61. doi:10.1016/j.jemermed.2007.05.031. PMID 18455060.

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[urlHypocalcemia:_Diagnosis_and_Treatment_-_Endotext_-_NCBI_Bookshelf-1] “Hypocalcemia: Diagnosis and Treatment – Endotext – NCBI Bookshelf”.

[urlST-Segment_Elevation_Resulting_From_Hyperkalemia_|_Circulation-2] “ST-Segment Elevation Resulting From Hyperkalemia | Circulation”.

[pmid21240584-3] Süfke S, Djonlagić H, Kibbel T (2010). “[Impairment of cardiac autonomic nervous system and incidence of arrhythmias in severe hyperglycemia]”. Med. Klin. (Munich) (in German). 105 (12): 858–70. doi:10.1007/s00063-010-1150-3. PMID 21240584.

[pmid18455060-4] Petrov D, Petrov M (2008). “Widening of the QRS complex due to severe hyperkalemia as an acute complication of diabetic ketoacidosis”. J Emerg Med. 34 (4): 459–61. doi:10.1016/j.jemermed.2007.05.031. PMID 18455060.

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