From the Research
Yes, hyperkalemia can cause right axis deviation on an electrocardiogram (ECG). Hyperkalemia, defined as a serum potassium level above 5.5 mEq/L, affects cardiac electrical conduction by altering the resting membrane potential of cardiac cells 1. As potassium levels rise, the heart's electrical axis can shift rightward, resulting in right axis deviation. This occurs because hyperkalemia causes partial depolarization of cell membranes, which affects the speed and direction of electrical impulse propagation through the heart.
The severity of ECG changes typically correlates with the degree of hyperkalemia, with mild elevations (5.5-6.0 mEq/L) sometimes showing only peaked T waves, while more severe hyperkalemia (>7.0 mEq/L) can cause right axis deviation along with widened QRS complexes, flattened P waves, and potentially life-threatening arrhythmias. Key considerations in managing hyperkalemia include:
- Identifying and addressing the underlying cause of hyperkalemia
- Administering treatments to rapidly lower serum potassium levels, such as calcium gluconate, insulin with glucose, and sodium bicarbonate
- Implementing measures to remove excess potassium from the body, including diuretics and dialysis
- Preventing recurrence through dietary adjustments and careful medication management
Treatment of hyperkalemia with these interventions will typically resolve ECG abnormalities as potassium levels normalize 2. It's crucial to monitor patients closely for signs of hyperkalemia and to be aware of the potential for hypoglycemia when using insulin therapy, adjusting dosing strategies as needed to minimize this risk 2.