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Hyperkalemia can do whatever it wants to the 12-lead ECG. Maintain a high index of suspicion and consider hyperkalemia when dealing with any bizzare rhythm. Consider some of the following ECG findings in Hyperkalemia:
Peaked T-waves (even when inverted)
Widening of the QRS (often marked)
Prolonged PR-interval
Flattening and eventual loss of P-waves
Tachydysrhythmias, pseudo ventricular tachycardia
Bizarre bradydysrhythmias, advanced AV Blocks and sinus pauses
Axis changes (especially RAD)
Fascicular & Bundle Branch Blocks
ST-segment changes (can mimic ACS)
Pseudo Brugada pattern
Sine wave morphology, asystole
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