Figure 319

Electrocardiographic changes associated with hypokalemia. A, The U wave may be a normal finding and is not specific for hypokalemia. B, When the amplitude of the U wave exceeds that of the T wave, hypokalemia may be present. The QT interval may appear to be prolonged; however, this is often due to mistaking the QU interval for the QT interval, as the latter does not change in duration with hypokalemia. C, Sagging of the ST segment, flattening of the T wave, and a prominent U wave are seen with progressive hypokalemia. D, The QRS complex may widen slightly, and the PR interval is often prolonged with severe hypokalemia. Hypokalemia promotes the appearance of supraventricular and ventricular ectopic rhythms, especially in patients taking digitalis [16].

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