Hypercalcemia-Induced New Onset Left Bundle Branch Block Mimicking Acute Myocardial Infarction in a Patient with Primary Hyperparathyroidism.
A 78-year-old women with a recent diagnosis of primary hyperparathyroidism presented with vague chest pain, and new onset left bundle block (LBBB) on the electrocardiogram (ECG) mimicking acute myocardial infarction (AMI). LBBB resolved without abnormal Q waves only after correction of hypercalcemia. The cardiac enzymes, including creatine kinase, creatine kinase-MB, and troponin-I were all within normal range. Hypercalcemia provoking ECG changes that mimic acute myocardial infarction is infrequently reported. To our knowledge, this is the first report of hypercalcemia-induced new onset LBBB mimicking AMI. Emergency physicians should include hypercalcemia-induced new onset LBBB on the ECG in the differential diagnosis of AMI.


BACKGROUND
Acute myocardial infarction; Hypercalcemia; Hyperparathyroidism; left bundle branch block.
Cardiovascular Center, Taichung Veterans General Hospital, Taichung;
Yu-Tsung
YT
Cheng
Cardiovascular Center, Taichung Veterans General Hospital, Taichung; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang-Ming University School of Medicine;
Chieh-Shou
CS
Su
Cardiovascular Center, Taichung Veterans General Hospital, Taichung; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang-Ming University School of Medicine;
Wei-Chun
WC
Chang
Cardiovascular Center, Taichung Veterans General Hospital, Taichung; ; Institute of Biomedical Engineering, National Yang-Ming University, Taipei;
Meng-Hsia
MH
Chiang
Cardiovascular Center, Taichung Veterans General Hospital, Taichung; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang-Ming University School of Medicine;
Chih-Tai
CT
Ting
Cardiovascular Center, Taichung Veterans General Hospital, Taichung; ; Department of Radiological Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Wei-Win
WW
Lin