Hypokalemia

A 40 yo F patient with h/o of alcoholism is admitted due to abdominal pain and vomiting.

Figure 1

There is a baseline artifacts (part of real-life ecg's). This is a regular narrow complex tachycarduia with prolonged QT/QTc. A QT interval that crosses the middle of an R to R is highly suspicious for for prolonged QTc. The QT interval is about 400 ms and at a rate of about 100-107 bpm, the QTc is  516-534 ms which is prolonged. There is also diffuse ST sagging. These ECG findings can be seen in hypokalemia. In this case, the K was 2.5. The tachycardia was due to alcohol withdrawal.

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