Which electrolyte abnormality would most likely cause a sine wave pattern on ECG?

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Multiple Choice

Which electrolyte abnormality would most likely cause a sine wave pattern on ECG?

The sine wave pattern on ECG is most characteristic of severe hyperkalemia. As potassium rises, the heart’s conduction becomes increasingly impaired, first with tall, peaked T waves, then widening of the QRS complex, and eventually the QRS and T waves blend into a sine-like waveform. In contrast, calcium abnormalities produce different patterns: hypercalcemia shortens the QT interval, while hypocalcemia lengthens it. Hypokalemia tends to cause flattened T waves, prominent U waves, and a longer QT, not a sine wave. So the sine wave pattern points to severe hyperkalemia.

The sine wave pattern on ECG is most characteristic of severe hyperkalemia. As potassium rises, the heart’s conduction becomes increasingly impaired, first with tall, peaked T waves, then widening of the QRS complex, and eventually the QRS and T waves blend into a sine-like waveform. In contrast, calcium abnormalities produce different patterns: hypercalcemia shortens the QT interval, while hypocalcemia lengthens it. Hypokalemia tends to cause flattened T waves, prominent U waves, and a longer QT, not a sine wave. So the sine wave pattern points to severe hyperkalemia.

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