Hypercalcaemia Mimicking STEMI on Electrocardiography
1Royal Sussex County Hospital, Brighton BN2 5BE, UK.
Case Reports in Medicine
|January 7, 2011
Insights
Hypercalcemia can cause electrocardiogram (ECG) changes that mimic acute myocardial infarction in low-risk patients. Prompt treatment of hypercalcemia resolved these concerning ECG findings.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Acute coronary syndrome (ACS) is a frequent reason for hospital admission.
- ST-segment elevation on an electrocardiogram (ECG) typically suggests a cardiac origin, such as myocardial infarction.
- However, alternative diagnoses must be considered in low-risk individuals presenting with these ECG changes.
Observation:
- A case is presented of a male patient with hypercalcemia.
- The patient had no discernible cardiac disease.
- The patient exhibited ECG changes that closely resembled those of an acute myocardial infarction.
Findings:
- The observed ECG abnormalities were not due to cardiac pathology.
- The ECG changes were directly linked to the patient's elevated calcium levels (hypercalcemia).
- Resolution of the ECG abnormalities occurred following successful treatment of the hypercalcemia.
Implications:
- Hypercalcemia should be considered in the differential diagnosis of ST-segment elevation on ECG, particularly in patients without clear cardiac risk factors.
- This case highlights the importance of a comprehensive diagnostic approach, including metabolic evaluation, for patients with ECG changes suggestive of myocardial infarction.
- Recognizing and treating hypercalcemia can prevent unnecessary cardiac interventions and improve patient outcomes.
Abstract:
Acute coronary syndrome is a common cause of presentation to hospital. ST segment elevation on an electrocardiogram (ECG) is likely to be cardiac in origin, but in low-risk patients other causes must be ruled out. We describe a case of a man with hypercalcaemia, no evidence of cardiac disease, and ECG changes mimicking acute myocardial infarction. These ECG changes resolved after treatment of the hypercalcaemia.
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