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Question

Tall tented T waves in hyperkalemia occur primarily due to:

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The correct answer is

Acceleration of ventricular repolarization

In hyperkalaemia the increased extracellular K+ raises the resting membrane potential and accelerates phase 3 ventricular repolarisation (faster potassium efflux). The ECG consequence is a tall, tented, narrow-based T wave.

Prolonged depolarisation (QRS widening) is a later sign of more severe hyperkalaemia, delayed atrial depolarisation causes P-wave flattening, and SA-node suppression explains bradyarrhythmias — none directly explains the tall tented T.

Hence, Acceleration of ventricular repolarization.

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