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The presence of peaked T waves on an ECG is a classic indicator of hyperkalemia, which is an elevated level of potassium in the blood. This finding occurs because high potassium levels affect the cardiac repolarization process. The Tall, symmetrical T waves typically appear as the condition worsens, and they can become increasingly pronounced with higher potassium concentrations.

In the early stages of hyperkalemia, these peaked T waves are often the most notable change seen on an ECG. As hyperkalemia progresses, additional ECG changes can emerge, such as widened QRS complexes and loss of P waves, which are also significant but not as characteristic as the peaked T waves.

Contextualizing this, while inverted T waves may be associated with other conditions and prolonged QT intervals are influenced by various factors, neither directly signals hyperkalemia. Similarly, flattened P waves can indicate other electrolyte disturbances or ischemic changes but are not specific to hyperkalemia. Understanding these specific ECG changes is crucial for diagnosing and managing hyperkalemia effectively in clinical settings.