Pseudo P pulmonale pattern associated with severe hypokalemia

This study presents the case of a 54-year-old man who presented with weakness in his lower extremities and tall P waves on electrocardiography (ECG). At admission, ECG revealed tall P waves (0.32 mV, lead II) at a serum potassium level of 1.21 mmol/L. After potassium supplementation, the amplitude of P waves decreased and returned to normal. A tall P wave may not be a real P pulmonale pattern but a pseudo P pulmonale pattern associated with hypokalemia.