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[Acquired QT-syndrome with syncopes in hypoparathyroidism]
F Hartmann-Hornberger1, R Rein, M Runge
11. Innere Abteilung des Krankenhauses Spandau.
Deutsche Medizinische Wochenschrift (1946)
|September 30, 1988
Summary
A patient experienced syncopes 20 years post-thyroid surgery due to low calcium and magnesium levels. Supplementation with vitamin D and calcium resolved symptoms, highlighting the importance of monitoring electrolytes after thyroidectomy.
Area of Science:
- Endocrinology
- Cardiology
- Nephrology
Background:
- Thyroid surgery can lead to long-term complications affecting mineral metabolism.
- Electrolyte imbalances, particularly hypocalcemia and hypomagnesemia, can manifest years after thyroidectomy.
Observation:
- A 42-year-old male presented with syncopes 20 years after thyroid surgery.
- Electrocardiogram (ECG) revealed a prolonged QT interval.
- Laboratory tests showed decreased calcium (1.1 mmol/l) and magnesium (0.6 mmol/l) levels, with hyperphosphatemia (2.8 mmol/l) and borderline parathormone.
Findings:
- The patient's syncopal episodes and prolonged QT interval were attributed to severe hypocalcemia and hypomagnesemia.
- The electrolyte disturbances were likely a delayed consequence of the previous thyroid operation, possibly related to parathyroid function impairment.
Implications:
- This case underscores the necessity of long-term monitoring of calcium, magnesium, and phosphate levels in patients with a history of thyroid surgery.
- Timely supplementation with vitamin D and calcium can effectively manage and resolve such delayed-onset electrolyte disturbances and associated cardiac symptoms.
- Awareness of these potential delayed complications is crucial for clinicians managing post-thyroidectomy patients.