Peaked T waves

Peaked T waves are taller than normal and sharp with a narrow base. They are classically associated with hyperkalaemia.

See also: T and U waves

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ECG Library (44)

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In the ECGquest archives, this ECG has been tagged with: - Dyspnoea 12-Lead Peaked T waves Hyperkalemia Dr Smith's ECG Blog CC BY-NC
Patient with Dyspnea. You are handed a triage ECG interpreted as “normal” by the computer.

This ECG is from a dialysis patient who presented with dyspnoea.

This ECG shows subtly peaked T waves and flat ST segments. The cause was hyperkalemia (6.3).

In the ECGquest archives, this ECG has been tagged with: - Muscle pains 12-Lead Long QT Peaked T waves Hyperkalemia Hypocalcaemia Dr Smith's ECG Blog CC BY-NC
Patient with Dyspnea. You are handed a triage ECG interpreted as “normal” by the computer. ‘Baseline’ ECG

This ECG is from a dialysis patient who presented with diaphoresis and muscle cramps.

This ECG shows subtly peaked T waves and long ST segments causing a long QT interval. The cause was hyperkalemia (6.6) and hypocalcemia.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Absent P waves Peaked T waves Accelerated idioventricular rhythm Hyperkalemia EMergucate CC-BY-NC-SA
ECG of the Week Interpretation – March 20th 2019

This ECG is from a man in his 60s who presented with fever and delirium. He has a history of renal failure, T2DM and cognitive impairment.

This ECG shows accelerated idioventricular rhythm with peaked T waves due to hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest 12-Lead Bradycardia Irregular Peaked T waves Wide QRS Hyperkalemia Dr Smith's ECG Blog CC BY-NC
A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB).

This ECG is from a patient who presented after a PEA arrest with ROSC after intubation and chest compressions.

This ECG shows irregular, slow, wide complex rhythm with peaked T waves due to hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - Hypotension 12-Lead Nonspecific baseline artefact Bradycardia Extra P waves Irregular Peaked T waves Wide QRS Second degree AV block Hyperkalemia Dr Smith's ECG Blog CC BY-NC
What will you do for this altered and bradycardic patient?

This ECG is from a woman in her 60s who presented from a nursing home with altered mental status, hypotension, hypoxia and bradycardia.

This ECG shows an irregular rhythm due to second degree AV block with wide QRS and peaked T waves. The cause was hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Inferior ST elevation Peaked T waves Reciprocal ST depression ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free

This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain returned.

This ECG shows ST elevation in V1, II, III and aVF with reciprocal ST depression in aVL. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Peaked T waves ST elevation in V1 Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician

This ECG is from a middle aged patient who presented with chest pain of uncertain duration.

This ECG shows ST elevation in V1 only. This was dynamic on serial ECGs. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Peaked T waves Right ventricular MI Dr Smith's ECG Blog CC BY-NC
The Interventionalist Refuses Angiography, and even to speak to the Emergency Physician – repeat ECG pain free

This ECG is from a middle aged patient who presented with chest pain of uncertain duration. This was the repeat ECG when pain free

This ECG shows ST elevation in V1 has resolved. This was dynamic on serial ECGs. The cause was a proximal RCA occlusion. The T waves were peaked but the potassium was normal.

In the ECGquest archives, this ECG has been tagged with: - Chronic kidney disease 12-Lead Incorrect Machine Interpretation Flat ST segment Peaked T waves Hyperkalemia Dr Smith's ECG Blog CC BY-NC
I saw this computer “normal” ECG in a stack of ECGs I was reading

This ECG is from a woman of unknown age who presented with a clotted dialysis shunt.

This ECG shows peaked T waves and flattened ST segments caused by hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - Chronic kidney disease 12-Lead Flat ST segment Peaked T waves Hyperkalemia Dr Smith's ECG Blog CC BY-NC
What is the diagnosis?

This ECG is from a patient on dialysis who presented after a fall.

This ECG shows flattened ST segments and peaked T waves due to hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - Loss of consciousness 12-Lead Long QT Peaked T waves Hyperkalemia Hypocalcaemia Dr Smith's ECG Blog CC BY-NC
Found comatose with prehospital ECG showing “bigeminal PVCs” and “Tachycardia at a rate of 156”

This ECG is from a patient with a history of diabetes who was found with a GCS of 4.

This ECG shows sinus rhythm with peaked T waves that were so narrow they were mistaken for separate QRS complexes. The cause was hyperkalemia due to acute renal failure.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Peaked T waves Wide QRS Hyperkalemia Dr Smith's ECG Blog CC BY-NC
Could you have prevented this young man’s cardiac arrest?

This ECG is from a young man who was found at the bottom of his basement stairs. He complained of right hip or leg pain but seemed confused about what had happened. He had a history of IV heroin abuse. Shortly after he had a wide complex PEA arrest and had a ROSC after 20 min of resuscitation with epinephrine, glucose, calcium and bicarb. This was his triage ECG before he arrested.