title: Electrocardiographical case. J wave and presyncope in a middle-aged woman.
abstract: 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.
authors.affiliation: Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India. kknnamboodiri@yahoo.co.in
authors.forename: N
authors.initials: N
authors.lastname: Namboodiri
authors.forename: S
authors.initials: S
authors.lastname: Bohora
authors.forename: S K
authors.initials: SK
authors.lastname: Dora
authors.forename: J A
authors.initials: JA
authors.lastname: Tharakan
mesh_terms: 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*