The T-P phenomenon on an electrocardiogram can serve as a reliable early indicator of alkalosis in alcoholic patients.
May support ECG alkalosis screening in alcoholics; hypothesis-generating and requires prospective validation before practice change.
IN THE COURSE of examining the charts of many alcoholic patients, an unusual electrocardiographic pattern was frequently observed which had two main features: (1) sinus tachycardia, and (2) relative prolongation of the QT interval (QTc), which in most cases was actually due to relative prolongation of the ST segment. Thus, the delayed T wave is closely followed by the next P wave, or the P wave may even begin on the downstroke of a T wave (Fig 1), and since this double peak strikes the eye at first glance it has been called T-P approximation or simply T-P. These changes which are illustrated best in leads II, III, AVF, and left precordial leads, have been found to be a reliable indicator of metabolic, respiratory, or mixed alkalosis. Since the electrocardiogram is usually obtained early in the course of a diagnostic survey, it has been helpful in directing attention to
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Carl S. Alexander (1965) studied this question.
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