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Electrocardiographic Pattern of Anteroseptal Myocardial Infarction Mimicked by Hyperkalemia-Induced Disturbance of Impulse Conduction

Morton F. Arnsdorf, MD

Arch Intern Med. 1976;136(10):1161-1163.

Abstract
In a patient with renal failure and shortness of breath, Q waves transiently appeared in the right precordial leads of the electrocardiogram (ECG) during episodes of hyperkalemia, without a substantial change in mean electrical axis. With restoration of the plasma potassium levels to normal, R waves reappeared in these leads. It is concluded that the transient development of Q waves in the right precordial leads during hyperkalemia resulted from a hyperkalemia-induced conduction disturbance. Hyperkalemia, by affecting conduction in Purkinje fibers or ventricular muscle, or both, disturbed the normal sequence of septal and anterior wall depolarization and resulted in an ECG pattern that mimicked that of anteroseptal myocardial infarction. Clinically, hyperkalemia-induced conduction disturbances of this type must be included in the differential diagnosis of the ECG that suggests an anteroseptal myocardial infarction.

(Arch Intern Med 136:1161-1163, 1976)

Author Affiliations
From the Section of Cardiology, Department of Medicine, Pritzker School of Medicine, University of Chicago.

Footnotes
Received for publication Oct 27, 1975; accepted Feb 18, 1976.

Reprint requests to Department of Medicine, University of Chicago Hospitals and Clinics, 950 E 59th St, Box 423, Chicago, IL 60637.

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