“In extreme hyperkalemia, the intraventricular conduction delay produces a sine wave configuration. There is no clear distinction between QRS and T. The heart is writing its own obituary.”
Dhruv opened his eyes.
Mira ran back to Dhruv. The monitor had indeed flattened into a sine wave—smooth, undulating, deadly. She ordered calcium gluconate, insulin, glucose, and a dialysis team. Thirty minutes later, the sine wave broke apart. A p-wave emerged. Then a narrow QRS.