[Hypercalcemia mimicking acute coronary syndrome]
Piotr Kukla1, Jarosław Paździerz, Marek Jastrzębski
1Oddział Internistyczno-Kardiologiczny, Szpital Specjalistyczny, im. H. Klimontowicza, Gorlice. kukla_piotr@poczta.onet.pl.
Kardiologia Polska
|September 20, 2013
Summary
Severe hypercalcemia can mimic heart attacks, causing chest pain and EKG changes. This study highlights two cases where high calcium levels led to ST-T segment abnormalities, crucial for accurate diagnosis.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Hypercalcemia, a condition of elevated calcium levels, can present with diverse symptoms.
- Electrocardiogram (EKG) abnormalities are common in various systemic diseases.
Observation:
- Two female patients, aged 28 and 69, presented with severe hypercalcemia (4.47 mmol/L and 4.8 mmol/L) and chest pain.
- EKG findings included ST segment elevation and negative T waves, mimicking acute coronary syndrome.
- Normal troponin levels and shortened corrected QT apex (250 ms and 206 ms) were noted, along with T wave humps.
Findings:
- The observed EKG changes in hypercalcemia can closely resemble those of acute myocardial infarction.
- Shortened corrected QT apex and T wave humps are potential indicators of hypercalcemia-induced cardiac manifestations.
Implications:
- Accurate differentiation between hypercalcemia and acute coronary syndrome is critical for appropriate patient management.
- Clinicians should consider hypercalcemia in the differential diagnosis of patients presenting with chest pain and ischemic EKG changes, especially with normal troponin levels.
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