Rosh Emergency Medicine Practice Test 2025 – 400 Free Practice Questions to Pass the Exam

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What ECG finding is indicative of hyperkalemia?

QT prolongation

Peaked T-waves

Peaked T-waves are a classic and early ECG finding associated with hyperkalemia. This is due to the effects of elevated potassium levels on myocardial repolarization. As potassium levels rise, the T-waves become increasingly tall and narrow, which can sometimes appear symmetrically peaked. This change is typically one of the first alterations noted on an ECG when hyperkalemia is present.

It's important to note that while other findings such as QT prolongation, ST elevation, and QRS widening may occur in the context of other conditions or as potassium levels rise further, peaked T-waves are specifically characteristic of early hyperkalemia. Monitoring these changes can be crucial in emergency settings, as they can help guide the treatment of hyperkalemia before more severe ECG changes develop, such as QRS widening, which indicates more advanced effects on cardiac conduction and increased risk of arrhythmias.

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ST elevation

QRS widening

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