PMC6197009_01
EKG upon presentation.. HR: 75 BPM Normal sinus rhythmPR interval 178 msQRS duration 72 msQT/QTc 494/551 ms Prolonged QTFlattened T waves and prominent U waves (arrows) with apparent QT interval prolongation
ZJCH_A_1514943_F0001_PB.jpg
PMC6197009_01_ZJCH_A_1514943_F0001_PB.jpg
F0001
Electrocardiogram (ECG) (Figure 1) showed no arrhythmias, but changes characteristic of hypokalemia with increased amplitude of the U-wave and marked corrected QT segment prolongation (QTc 551 ms).
EKG after electrolyte supplementation.. HR: 92 BPM Normal sinus rhythmPR interval 132 msQRS duration 72 msQT/QTc 360/445 ms
ZJCH_A_1514943_F0002_PB.jpg
PMC6197009_01_ZJCH_A_1514943_F0002_PB.jpg
F0002
Serial electrocardiogram monitoring showed resolution of ECG changes (Figure 2).
Serum potassium level Day 1 - Day 13.
ZJCH_A_1514943_F0003_B.jpg
PMC6197009_01_ZJCH_A_1514943_F0003_B.jpg
F0003
Aggressive supplementation of electrolytes was initiated (Table 1), however despite supplementation with enteral and parenteral potassium as well as magnesium and phosphate, potassium level failed to increase (Figure 3) and subsequently she had a sinus bradycardia followed by asystole.