Electrocardiographical case. Young man with generalised myalgia

A Ngo, SH Lim, RA Charles, SH Goh
Correspondence: Dr Adeline Ngo, Adeline_ngo@singhealth.com.sg

ABSTRACT
A 24-year-old man presented with generalised malaise and myalgia for three days. He presented to the Emergency Department after a fall at his workplace due to weakness. 12-lead electrocardiogram (ECG) showed normal sinus rhythm with ST depression in the leads V4 to V6, with a U wave. The tallest U wave appeared in V3. These ECG features are characteristic of hypokalaemia. ECG changes in hypokalaemia and differential diagnosis are discussed. A second case of thyrotoxic periodic paralysis with similar ECG changes of hypokalaemia is also presented.

Keywords: hypokalaemia, hypokalemic periodic paralysis
Singapore Med J 2005; 46(1): 38-41