Severe hypocalcemia simulating ST-elevation myocardial infarction.
ST-elevation myocardial infarction (STEMI) is an emergency situation in which immediate measures for myocardial reperfusion are needed. The diagnosis is based on the recognition of ST-segment elevation in the electrocardiogram (ECG). In case of coronary artery occlusion, ST-segment elevation is caused by an injury current from the ischemic myocardium. Rarely, other mechanisms may lead to ECG changes mimicking STEMI. In our case, a 65-year-old man was presented to our institution with ECG abnormalities suggestive of STEMI. However, coronary angiography showed open arteries. Laboratory tests revealed severe hypocalcemia caused by a deficiency of vitamin D. After calcium replacement therapy, the ECG normalized, and the patient was discharged in good condition. Only a few case reports on hypocalcemia-induced ST-segment elevation exist, and the mechanism remains unknown.
Department of Cardiology, Tampere University Hospital Heart Center, PO Box 2000, FI-33521 Tampere, Finland. erkki.ilveskoski@uta.fi
Erkki
E
Ilveskoski
Samuel
S
Sclarovsky
Kjell
K
Nikus
D000368:Aged; D002118:Calcium / Q000627:therapeutic use; D017023:Coronary Angiography; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D006321:Heart / Q000503:physiopathology; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D014807:Vitamin D / Q000627:therapeutic use
D014807:Vitamin D; D002118:Calcium