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Just hypercalcaemia or acute ST elevation myocardial infarction? A review of hypercalcaemia-related

Soumya Patnaik1, Yu Kuang Lai1

  • 1Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.

BMJ Case Reports
|October 23, 2015
PubMed

Insights

Elderly patients with confusion and falls may have electrolyte issues. Electrocardiograms (ECGs) can suggest these, but hypercalcemia can mislead ECG interpretation.

Area of Science:

  • Cardiology
  • Geriatrics
  • Internal Medicine

Background:

  • Elderly patients with confusion and recurrent falls require urgent diagnosis.
  • Infections, stroke, cardiac events, and electrolyte imbalances are key differential diagnoses.

Observation:

  • Electrocardiography (ECG) is a valuable non-invasive tool for identifying electrolyte disturbances.
  • This case highlights that ECG findings in hypercalcemia can be atypical and misleading.

Findings:

  • Hypercalcemia can present with varied and sometimes atypical ECG manifestations.
  • Misinterpretation of ECG in hypercalcemia can delay accurate diagnosis and treatment.

Implications:

  • Clinicians must maintain a high index of suspicion for hypercalcemia in elderly patients with confusion and falls, even with seemingly normal ECGs.
  • A comprehensive diagnostic approach beyond ECG interpretation is crucial for managing these complex cases.

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