Electrocardiographical case. J wave and presyncope in a middle-aged woman.
A 46-year-old woman presented with three episodes of presyncope in the previous two days. Electrocardiogram (ECG) showed sinus rhythm, relatively short QT interval (QTc of 340 msec) and prominent J-waves in the inferior leads. Biochemical evaluation revealed serum calcium of 17.4 mg/dL, phosphorus of 2.3 mg/dL and alkaline phosphatase of 533 IU/ml. She was managed with saline diuresis followed by elective parathyroidectomy. ECG became normal with the disappearance of J-waves after correction of hypercalcaemia. She was asymptomatic at six months of follow-up. The presence of J-waves (Osborne waves) in hypercalcaemia has rarely been reported.
Namboodiri
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Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India. kknnamboodiri@yahoo.co.in
Bohora
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Dora
S K
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Tharakan
J A
JA
D004562:Electrocardiography; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D006934:Hypercalcemia / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging; D013575:Syncope / Q000209:etiology*