[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.170.64.36. Please contact the publisher to request reinstatement.
Views 1,022
Citations 0
Challenges in Clinical Electrocardiography
June 7, 2021

Pathologic U Waves Secondary to Severe Hypophosphatemia During Refeeding Syndrome

Author Affiliations
  • 1Department of General Medicine, Christchurch Hospital, Christchurch, New Zealand
  • 2Department of Medicine, Christchurch School of Medicine, Otago University, Christchurch, New Zealand
JAMA Intern Med. Published online June 7, 2021. doi:10.1001/jamainternmed.2021.2233

A patient in their early 20s was admitted to the hospital’s acute medical unit complaining of palpitations and weakness. During the previous 3 months, the patient had experienced depression and suicidal ideations. Four days prior to admission, the patient had stopped eating and drinking but had eaten a banana on the way to the hospital. Initial observations of the patient were: weight, 62 kg (7 kg less than baseline); body mass index (calculated as weight in kilograms divided by height in meters squared), 20; heart rate, 110 beats/min; blood pressure, 122/66 mm Hg; jugular venous pressure, 0 cm H2O; respiratory rate, 18 breaths/min; and oxygen saturation, 99%. An electrocardiogram (ECG) performed on admission demonstrated sinus tachycardia with inverted T waves and pathologic U waves (upward deflection >2 mm immediately after the T wave), most prominent in V2 through V4 (Figure, A).

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×