Classic teaching of the chronological ECG changes of hyperkalemia include:
- Peaked T waves
- Prolongation of PR interval
- Widening QRS Complex
- Loss of P wave
- “Sine Wave”
- Asystole
The order of ECG changes of hyperkalemia have been defined in the experimental setting, but no uniform order has been documented in animal models (Ettinger, Regan, and Oldewurtel 1974)*. The relationship between serum potassium and cardiac manifestations is even less clear in the clinical setting (Acker et al. 1998)*.