From Glancy DL. J La State Med Soc 2007; 159:5-7
Elias Hanna, MD, Cardiology
Hypokalemia:
Flat T with K~3ST depression with prominent T
(actually U) and prolonged QT
when K<2.5-3
• Hypokalemia: -T progressively flattens -U wave more and more prominent (looks like
T) -ST-segment more and more depressed
Large U wave simulates and hides T wave with severe hypokalemia, the ST-T pattern may mimick: ST-segment depression with a flat or upright wide “T” wave (actually U) and a prolonged “QT” interval (actually QTU)
On the other hand, the pattern of T inversion is not seen with hypokalemia:
ST depressionischemia
ST
elevation
ischemia
Hanna EB, Glancy DL. CCJM June 2011