Hypoaldosteronism electrocardiogram

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

Overview

In hypoaldosteronism there are no specific ECG findings. However, hypoaldosteronism predisposes to hyponatremia (decreased absorption) and hyperkalemia (decreased excretion). Severe hyponatremia may present with EKG changes of ST segment elevation mimicking acute myocardial infarction. Hyperkalemia leads to depression of SA node and conduction pathways such as AV node and His-Purkinje system causing bradycardia and conduction defects.

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Electrocardiogram

• There are no specific ECG findings associated with hypoaldosteronism. However, hypoaldosteronism predisposes to hyponatremia (decreased absorption) and hyperkalemia (decreased excretion).
  • Hyperkalemia leads to depression of SA node and conduction pathways such as AV node and His-Purkinje system. Findings on an ECG suggestive of hyperkalemia include:
    • Peaked T waves in chest leads
    • Widening of the QRS complex (seen with potassium level ≥ 6.5 mEq/L)
    • Prolonged QRS interval and conduction blocks such as bundle branch blocks or fascicular blocks (seen with potassium level ≥ 7 mEq/L)
    • Ventricular fibrillation, PEA and cardiac arrest (seen with potassium level ≥ 9 mEq/L)
  • Hyponatremia slow cardiac pacemaker activity. Findings on an ECG suggestive of hyperkalemia include:
    • ST segment elevation mimicking acute myocardial infarction