EKG changes in adrenal crisis

Q: 37 year old female admitted to ICU with hypotension, hyponatremia, hyperkalemia, metabolic acidosis, and hypoglycemia. Hypotensive shock is refractory to fluid resuscitation. You highly suspect adrenal crisis. You order all required workup. What changes you expect to see in EKG with adrenal crisis?


Answer: Adrenal crisis may cause T wave changes from peaked T waves secondary to hyperkalemia to deep negative T waves. More importantly it causes prolongation of the QT interval which should be considered serious as it may degenerate into ventricular arrhythmias.