title: Global T-wave inversions with isolated hypomagnesemia.
abstract: BACKGROUND
  The physiological actions of magnesium within the cardiac conduction system and myocytes have yet to be fully elucidated. Because concurrent hypocalcemia or hypokalemia were also present in previous human reports, specific electrocardiographic effects of isolated hypomagnesemia have not been clearly delineated.
  
  
  OBJECTIVE
  We report a case in which dynamic electrocardiogram (ECG) changes were demonstrated in isolated hypomagnesemia.
  
  
  METHODS
  A 37-year-old man with history of heavy alcohol use was admitted for syncope. The ECG showed global T-wave inversions with prolonged corrected QT (QTc) duration on ECG. Extensive work-up including cardiac catheterization was unremarkable. His serum magnesium was noted to be low at 1.1 mg/dL, and his serum calcium and potassium were within normal limits. The patient received magnesium infusion with subsequent ECGs showing resolution of his global T-wave inversions and prolonged QTc.
  
  
  CONCLUSIONS
  This case is unique because it reports dynamic ECG changes in a patient with isolated hypomagnesemia. Although isolated hypomagnesemia is commonly believed to result in dysrhythmia, we were unaware of any previous cases of ECG abnormalities in humans. Clinically, we advise checking serum magnesium and correcting hypomagnesemia when prolonged QTc duration and global T-wave inversions are seen on ECG.
authors.affiliation: Department of Cardiovascular Medicine, University of California-Davis Medical Center, Sacramento, California.
authors.forename: Ting F
authors.initials: TF
authors.lastname: Tsai
authors.forename: Alyssa C
authors.initials: AC
authors.lastname: Browning
authors.forename: John
authors.initials: J
authors.lastname: Rutledge
mesh_terms: D000328:Adult; D063425:Binge Drinking / Q000150:complications / Q000503:physiopathology*; D004562:Electrocardiography; D006801:Humans; D008274:Magnesium / Q000097:blood* / Q000627:therapeutic use*; D008297:Male; D013575:Syncope / Q000209:etiology; D014839:Vomiting / Q000150:complications / Q000503:physiopathology*
chemical_list: D008274:Magnesium
keywords: T-wave inversions; electrocardiogram; electrolyte abnormalities; hypomagnesemia