A Clinical Correlative Study of the Electrocardiogram in Electrolyte Imbalance

IN ELECTROLYTE imbalance the failure of the electrocardiogram to correlate with clinical and laboratory findings may result in both diagnostic and therapeutic dilemmas. Several authors 14 in particular have stressed the lack of conformity of electrocardiographic manifestations with the serum levels of potassium. This disparity has been attributed to the presence of electrocardiographic alterations from other causes or to concomitant abnormalities of other electrolytes. For example, Roberts and Magida5 6 studied the influence of the acid-base balance experimentally and concluded that electrocardiographic changes suggesting hyperkalemia and hypokalemia could be induced respectively by acidosis and alkalosis, and that such alterations were dependent upon the pH rather than the actual serum potassium concentration. Tarail,7 on the other hand, was unable to establish any correlation between serum pH, sodium, or calcium with the intensity of potassium effects reflected in clinical electrocardiograms. Attempts have also been made to clarify the apparent lack of correlation between the electrocardiogram and the actual serum electrolyte