I was reading through the list of EKGs and saw this one. What is it diagnostic of? (hint: 2 diagnoses in one)
There is a very long, flat, ST segment, resulting in a long QT (most long QT is due to a wide T-wave, not a long ST segment). This is diagnostic of hypocalcemia. There are also peaked T-waves of hyperkalemia. This is a common combination in dialysis patients.
The ionized calcium was 2.29 mg/dL (normal is 4.40-5.20). The K was 6.2 mEq/L.
Here are the symptoms she had (very typical for hypocalcemia):
Dialysis patient with left upper extremity numbness and tingling, lightheadedness, perioral numbness and tingling, and bilateral lower extremity stocking glove numbness and tingling.
She was given 6 grams of calcium gluconate and K was shifted.
Here is the subsequent ECG: