Hyperkalemia vs Hyperacute T wave (or Lytes vs Lytics)

Are there subtle clues to differentiating the peaked T waves of hyperkalemia from early repolarization or new onset ischemia?  Dr. Smith suggest there are.  Check out his blog post see if you can appreciate the differences.

Hyperkalemia

• peaked, tented coming to a sharp point
• flat ST segment
• long QRS

Hyperacute

• slightly more blunt peak
• ST segment less upward concavity, more linear, steeper incline, resulting in wider T wave
• QRS is normal

Copa Cardiogram #59