Clinical Resources

Hyperkalemia ECG Risk Calculator

ECG Manifestations and Risk Assessment for Hyperkalemia

Section 1 — Lab Values

Serum Potassium (mEq/L)

mEq/L

Serum Sodium (mEq/L)

mEq/L

Ionized Calcium (mmol/L) — optional

mmol/L

Low calcium worsens hyperkalemia effects

pH (ABG) — optional

Acidosis shifts K+ extracellularly, worsening hyperkalemia

Creatinine (mg/dL)

mg/dL

Section 2 — ECG Findings

Peaked/tall T wavesTent-like, symmetric — earliest ECG sign

Prolonged PR interval (>200 ms)

Widened QRS (>110 ms)

Flattened or absent P waves

Sine wave patternPre-arrest rhythm — emergency

Ventricular fibrillation or arrest

Bradycardia

Heart block (any degree)

Section 3 — Clinical Context

Renal failure (acute or chronic)

Diabetes mellitus

On ACE inhibitor / ARB / aldosterone antagonist

On digitalisPotassium toxicity enhanced with digoxin

Symptoms presentWeakness, paralysis, palpitations

Results

Potassium Level Category —

ECG Severity —

Overall Risk Level —

Enter serum potassium to begin assessment.

Reference

Mattu A et al. Electrocardiographic manifestations of hyperkalemia. Am J Emerg Med. 2000;18(6):721-729.