Hypercalcaemia and a Brugada-like ECG: An independent risk factor for fatal arrhythmias

Zeb, Mehmood; McKenzie, Daniel B; Naheed, Bushra; Gazis, T; Morgan, John M.; Staniforth, Andrew

doi:10.1016/j.resuscitation.2010.04.025

Cited by 6 publications

(13 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[7][8][9] Hypercalcemia was associated with QT interval shortening and delayed cardiac conduction; these ECG changes were restored when serum Ca 2+ levels returned to the normal range. Brugada-type ECG findings have been reported in the right precordial leads in the setting of hypercalcemia, in two case reports, 13,14 and were found in 6% of patients with hypercalcemia in this study. The frequency of J point elevation was not different among causes of hypercalcemia.…”

Section: Discussionsupporting

confidence: 61%

“…18 In this study, 6% of patients with hypercalcemia exhibited the scooped appearance. Brugada-type ECG findings have been reported in the right precordial leads in the setting of hypercalcemia, in two case reports, 13,14 and were found in 6% of patients with hypercalcemia in this study. Furthermore, this study demonstrated that hypercalcemia was also associated with early repolarization, as was the case in previous case reports.…”

Section: Discussionsupporting

confidence: 61%

“…arrhythmogenic substrate, is increased in patients with short QT syndrome, hypercalcemia does not increase QT interval dispersion, despite a shortened QT interval. 20 Actually, sodium channel blocker challenge, a provocative test for Brugada syndrome, is negative at normocalcemic state in a patient with hypercalcemia-induced Brugada type ECG, 13 and it is positive after parathyroidectomy in another patient with hypercalcemia-induced Brugada type ECG. Data from our study and from other studies suggest that J point elevation likely occurs in the setting of a shortened QT interval.…”

Section: Discussionmentioning

confidence: 99%

“…13,16 Therefore, this study aimed to investigate the role of hypercalcemia in both J point elevation and arrhythmia. 13,16 Therefore, this study aimed to investigate the role of hypercalcemia in both J point elevation and arrhythmia.…”

mentioning

confidence: 99%

“…Furthermore, the association of hypercalcemia with fatal arrhythmias has been described in only a few case reports and is not well understood. 13,16 Therefore, this study aimed to investigate the role of hypercalcemia in both J point elevation and arrhythmia.…”

mentioning

confidence: 99%

See 4 more Smart Citations

High Frequency of Early Repolarization and Brugada-Type Electrocardiograms in Hypercalcemia

Sonoda

Watanabe

Hisamatsu

et al. 2015

Ann Noninvasive Electrocardiol

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 61%

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

High Frequency of Early Repolarization and Brugada-Type Electrocardiograms in Hypercalcemia

Sonoda

Watanabe

Hisamatsu

et al. 2015

Ann Noninvasive Electrocardiol

View full text Add to dashboard Cite

show abstract

Hypercalcemia-Induced ST-Segment Elevation Mimicking Acute Myocardial Injury: A Case Report and Review of the Literature

Abugroun

Tyle

Faizan

et al. 2020

Case Reports in Emergency Medicine

View full text Add to dashboard Cite

ST-segment elevation in absence of acute coronary syndrome can be seen in multiple conditions, including acute pericarditis and coronary vasospasm, but it is rarely seen with severe hypercalcemia. e authors present a case of an 81-year-old female with a history of stage 4 squamous cell cancer of the lung, who presented to the emergency room with profound fatigue, weakness, anorexia, and drowsiness two weeks after her first chemotherapy cycle. Additionally, she had complaints of right-sided chest pain associated with worsening shortness of breath, as well as right arm numbness. An EKG obtained on arrival to the hospital showed diffuse ST-segment elevation (leads V3-V6, I, II, III, and aVF). Basic lab work found a calcium level of 20.4 mg/dl with elevated parathyroid hormone-related protein (PTHrP) of 135 pg/ml. Troponin I remained within normal limits. Serial EKS obtained during the patient's hospitalization demonstrated resolution of the ST elevation as calcium level normalized. is case emphasizes the importance of hypercalcemia as a differential diagnosis for ST-segment elevation and QT shortening when acute coronary syndrome is not present. Awareness of these EKG changes is critical for early diagnosis, recognition, and appropriate treatment.

show abstract

Epidemiology, clinical features, and management of severe hypercalcemia in critically ill patients

Mousseaux

Dupont

Rafat

et al. 2019

Ann. Intensive Care

View full text Add to dashboard Cite

BackgroundSevere hypercalcemia (HCM) is a common reason for admission in intensive-care unit (ICU). This case series aims to describe the clinical and biological features, etiologies, treatments, and outcome associated with severe HCM. This study included all patients with a total calcemia above 12 mg/dL (3 mmol/L) admitted in two ICUs from January 2007 to February 2017.Results131 patients with HCM were included. HCM was related to hematologic malignancy in 58 (44.3%), solid tumors in 29 (22.1%), endocrinopathies in 16 (12.2%), and other causes in 28 (21.3%) patients. 108 (82.4%) patients fulfilled acute kidney injury (AKI) criteria. Among them, 25 (19%) patients required renal replacement therapy (RRT). 51 (38.9%) patients presented with neurological symptoms, 73 (55.7%) patients had cardiovascular manifestations, and 50 (38.1%) patients had digestive manifestations. The use of bisphosphonates (HR, 0.42; 95% CI, 0.27–0.67; P < 0.001) was the only treatment significantly associated with a decrease of total calcemia below 12 mg/dL (3 mmol/L) at day 5. ICU and Hospital mortality rates were, respectively, 9.9% and 21.3%. Simplified Acute Physiologic Score (SAPS II) (OR, 1.05; 95% CI 1.01–1.1; P = 0.03) and an underlying solid tumor (OR, 13.83; 95% CI 2.24–141.25; P = 0.01) were two independent factors associated with hospital mortality in multivariate analysis.ConclusionsHCM is associated with high mortality rates, mainly due to underlying malignancies. The course of HCM may be complicated by organ failures which are most of the time reversible with early ICU management. Early ICU admission and prompt HCM management are crucial, especially in patients with an underlying solid tumor presenting with neurological symptoms.

show abstract

Hypercalcaemia and a Brugada-like ECG: An independent risk factor for fatal arrhythmias

Cited by 6 publications

References 5 publications

High Frequency of Early Repolarization and Brugada-Type Electrocardiograms in Hypercalcemia

High Frequency of Early Repolarization and Brugada-Type Electrocardiograms in Hypercalcemia

Hypercalcemia-Induced ST-Segment Elevation Mimicking Acute Myocardial Injury: A Case Report and Review of the Literature

Epidemiology, clinical features, and management of severe hypercalcemia in critically ill patients

Contact Info

Product

Resources

About