Ashizawa Naoto, Arakawa Syuji, Koide Yuji, Toda Genji, Seto Shinji, Yano Katsusuke
Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki.
Intern Med. 2003 Apr;42(4):340-4. doi: 10.2169/internalmedicine.42.340.
We report a case of hypercalcemia in an elderly patient due to vitamin D intoxication with clinical features and electrocardiogram (ECG) findings mimicking acute myocardial infarction. A 78-year-old man was referred to our department with symptoms of general fatigue, anorexia and chest pain. The ECG demonstrated ST elevation in leads V1 to V3 and diffuse T wave flattening, resulting in myocardial infarction being suspected. However, his symptoms, including chest pain, gradually improved and the ECG returned to normal in accordance with a fall in his serum calcium level. We introduce the use of QaTc interval shortening in differentiating ST-T changes of hypercalcemia from those of true myocardial ischemia.
我们报告了一例老年患者因维生素D中毒导致高钙血症的病例，其临床特征和心电图（ECG）表现酷似急性心肌梗死。一名78岁男性因全身乏力、厌食和胸痛症状被转诊至我科。心电图显示V1至V3导联ST段抬高及弥漫性T波低平，怀疑为心肌梗死。然而，他包括胸痛在内的症状逐渐改善，且随着血清钙水平下降，心电图恢复正常。我们介绍了利用校正QTc间期缩短来鉴别高钙血症的ST-T改变与真正心肌缺血的ST-T改变。
