Learning Points:
- When a patient is bradycardic, especially if irregular, one must always think of hyperK and one must get a 12-lead ECG.
- One must recognize this pattern as hyperK
- Calcium’s effect is almost miraculous
- Slow atrial fibrillation implies an sick AV node, or one affected by electrolytes, ischemia, or medications/drugs. Â Otherwise, the ventricular response should be fast.