ECG: Prolong PR interval with Generalized Up sloping ST Depression in Hypokalaemia Patient.

This is the ECG of 23 years old lady, post partum D24 who presented with generalized body weakness for 3/52 duration and unable to ambulate for 2/7 duration. Otherwise, no diarrhea or vomiting, no fever, no PV bleeding or foul smelling discharge.

She also has similar presentation during her last post partum but did not seek medical attention and claim that the problem resolves spontaneously.

On examination, patient is conscious and alert, hydration and perfusion status is good, CRT less than 2 second, good pulse volume. Examination of heart, lung and abdomen are normal. Neurological assessment revealed generalized body weakness with power of 2/5, hypotonic, hyporeflexia and intact sensation. Patient also have weakness of the right Sternocledomastoid and trapezius muscle weakness ?Accessory nerve involvement.

ECG shows sinus rhythm with prolong PR interval and generalized up sloping ST depression.

His potassium level is 1.6 mmol/l with other electrolytes are normal. VBG shows metabolic acidosis and random blood sugar is 5.5.