Hyperkalemia ECG Changes Mnemonic [Explained with ECG Strips]

Hyperkalemia ECG Changes Mnemonic

Hyperkalemia is a condition in which there is an abnormally high level of potassium in the blood, it can have potentially serious consequences on the body, including affecting the heart’s rhythm; as demonstrated by ECG changes. Today, in this article we are going to share with you an easy-to-remember mnemonic for ECG changes in hyperkalemia. But before jumping to the mnemonic, let’s take a quick look at the classic ECG changes in hyperkalemia.

ECG Changes in Hyperkalemia

Here’s a quick overview of all ECG changes commonly seen in Hyperkalemia:

Hyperkalemia ECG changes in a nutshell 🙂

Let’s break this down and look at each of these Hyperkalemia ECG changes in more detail.

  1. T Wave

  • Tall Tented T Waves (a.k.a Peaked T waves) at serum potassium level 6.0 mEq/L or more

Elevated serum potassium levels cause the T waves on the ECG to become tall and narrow. The T waves can appear like the letter “tented,” which is why they are often called “peaked T waves”. Here’s a classic representation of Tall tented T waves:

Tall tented T waves

2. P Wave

  • Flattening of the P wave
  • Widening of the P wave
  • P wave may disappear

The P wave is a representation of the electrical activity associated with atrial depolarization (contraction of the atria). Elevated potassium levels can cause the P wave to become smaller and harder to detect.

3. PR Interval

  • Prolongation of the PR interval

Prolongation of the PR interval

4. QRS Complex

  • Broadening of the QRS complex

The QRS complex demonstrates the electrical activity associated with ventricular depolarization (contraction of the ventricles). When potassium levels are high, the electrical impulses can be disrupted, causing the QRS complex to become widened.

Broadening of the QRS complex


5. Sine-Wave Pattern/Asystole

  • Loss of P-Wave
  • No ECG waves can be differentiated, seen when serum potassium levels are > 9.0 mEq/L
  • Asystole > FLAT ECG

Sine-Wave Pattern

6. Ventricular Fibrillation

In severe cases of hyperkalemia, the heart can develop life-threatening arrhythmias, including ventricular fibrillation, which can lead to cardiac arrest and death.

Ventricular Fibrillation


Hyperkalemia ECG Changes Mnemonic

Here’s a helpful mnemonic for ECG changes in Hyperkalemia: 🙂

TPRSA Mnemonic for ECG Changes in Hyperkalemia

T Tall Tented T Waves
P P wave widening/flattening
PR Prolongation
R QRS Complex Widening
S Sine Wave Pattern
A Asystole


Hyperkalemia ECG Changes Mnemonic
TPRSA Mnemonic for ECG Changes in Hyperkalemia

Tell us how you found this blog post. Share with us your mnemonic for ECG changes in hyperkalemia in the comment box below.

Happy learning! 🙂


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