The Uncommon ECG Signature of Hypokalemia: Left Main Coronary Equivalent
Mahsa Borjzadehgashtaseb1, Alireza Arzhangzadeh1, Roozbeh Narimani Javid2
1Department of Cardiology, School of Medicine Shiraz University of Medical Sciences Shiraz Iran.
Clinical Case Reports
|November 12, 2025
Insights
Severe hypokalemia can mimic electrocardiogram (ECG) findings of left main coronary artery disease. Promptly correcting electrolyte imbalances is crucial to prevent misdiagnosis and avoid unnecessary invasive cardiac procedures.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Electrocardiogram (ECG) abnormalities can indicate serious cardiac conditions.
- Left main coronary artery disease presents with specific ECG changes.
- Hypokalemia, or low potassium levels, can affect cardiac function.
Purpose of the Study:
- To highlight a case where severe hypokalemia mimicked ECG findings of left main coronary artery disease.
- To emphasize the importance of considering electrolyte disturbances in cardiac diagnoses.
Main Methods:
- Case report presentation.
- Review of patient's ECG findings and electrolyte levels.
- Correlation of clinical presentation with diagnostic data.
Main Results:
- Severe hypokalemia presented with ECG changes typically associated with left main coronary artery disease.
- Differential diagnosis was considered based on electrolyte levels.
Conclusions:
- Severe hypokalemia can masquerade as acute coronary syndromes on ECG.
- Early identification and management of electrolyte imbalances are critical to prevent misdiagnosis.
- Avoiding unnecessary invasive procedures through accurate diagnosis is essential.
Abstract:
This case highlights that severe hypokalemia can mimic the ECG findings associated with left main coronary artery disease. Early recognition and appropriate correction of electrolyte disturbances are essential in managing such presentations and avoiding misdiagnosis and unnecessary invasive procedures.
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