Electrocardiogram in Asiatic cholera. Separated studies of effects of hypovolaemia, acidosis, and potassium loss.

Carpenter, Charles C. J.; Biern, Robert O.; Mitra, P. P.; Sack, R. Bradley; Dans, Peter E.; Wells, S. A.; Khanra, S S

doi:10.1136/hrt.29.1.103

Cited by 6 publications

(2 citation statements)

References 16 publications

(23 reference statements)

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“…Increased voltages of S wave amplitude (manifest as increased QRS peak to peak amplitude) was an early sign of hyperkalemia in calves of the present study population. Our finding was consistent with previous observations in calves with diarrhea and critically ill humans with hyperkalemia, acidemia, and diarrhea because of cholera . Dehydration and hemoconcentration are common in hyperkalemic diarrheic calves and the resultant hypovolemia decreases ventricular chamber volumes.…”

Section: Discussionsupporting

confidence: 93%

“…Our finding was consistent with previous observations in calves with diarrhea 21 and critically ill humans with hyperkalemia, acidemia, and diarrhea because of cholera. 50 Dehydration and hemoconcentration are common in hyperkalemic diarrheic calves 5,7,12 and the resultant hypovolemia decreases ventricular chamber volumes. The effect of heart chamber volume on the amplitude of Q, R, and S waves is called the Brody phenomenon, 51 whereby the intracavitary blood mass augments the radial components and reduces the tangential components of the cardiac dipole.…”

Section: Thismentioning

confidence: 99%

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Electrocardiographic findings in 130 hospitalized neonatal calves with diarrhea and associated potassium balance disorders

Trefz

Lorenz

Constable

2018

Veterinary Internal Medicne

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BackgroundHyperkalemia in neonatal diarrheic calves can potentially result in serious cardiac conduction abnormalities and arrhythmias.ObjectivesTo document electrocardiographic (ECG) findings and the sequence of ECG changes that are associated with increasing plasma potassium concentrations (cK+) in a large population of neonatal diarrheic calves.AnimalsOne hundred and thirty neonatal diarrheic calves (age ≤21 days).MethodsProspective observational study involving calves admitted to a veterinary teaching hospital.ResultsHyperkalemic calves (cK+: 5.8‐10.2, blood pH: 6.55‐7.47) had significantly (P < .05) longer QRS durations as well as deeper S wave, higher T wave, and higher ST segment amplitudes in lead II than calves, which had both venous blood pH and cK+ within the reference range. The first ECG changes in response to an increase in cK+ were an increase in voltages of P, Ta, S, and T wave amplitudes. Segmented linear regression indicated that P wave amplitude decreased when cK+ >6.5 mmol/L, S wave amplitude voltage decreased when cK+ >7.4 mmol/L, QRS duration increased when cK+ >7.8 mmol/L, J point amplitude increased when cK+ >7.9 mmol/L, and ST segment angle increased when cK+ >9.1 mmol/L. P wave amplitude was characterized by a second common break point at cK+ = 8.2 mmol/L, above which value the amplitude was 0.Conclusions and Clinical ImportanceHyperkalemia in neonatal diarrheic calves is associated with serious cardiac conduction abnormalities. In addition to increased S and T wave amplitude voltages, alterations of P and Ta wave amplitudes are early signs of hyperkalemia, which is consistent with the known sensitivity of atrial myocytes to increased cK+.

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Section: Discussionsupporting

confidence: 93%