严重低钙血症酷似急性冠脉综合征。
Severe hypocalcaemia mimicking acute coronary syndrome.
机构信息
Department of Internal Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
Department of Internal Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA.
出版信息
BMJ Case Rep. 2023 Nov 28;16(11):e255652. doi: 10.1136/bcr-2023-255652.
Hypocalcaemia is a common electrolyte deficiency that can be found in up to 28% of hospitalised patients. It may affect cardiac and smooth muscle tone, leading to ECG abnormalities and, in rare cases, coronary spasms and heart failure. This is a case of a pregnant woman in preterm labour who developed vasospastic angina and corrected QT interval (QTc) prolongation on ECG from severe hypocalcaemia, which likely occurred due to iatrogenic hypermagnesaemia. She had a negative diagnostic workup for acute coronary syndrome, and her chest pain and QTc prolongation ultimately resolved with intravenous electrolyte repletion. This case highlights the importance of considering hypocalcaemia on the differential of chest pain that is possibly cardiac in origin.
低钙血症是一种常见的电解质缺乏症，在多达 28%的住院患者中都能发现。它可能影响心脏和平滑肌的张力，导致心电图异常，在极少数情况下，还会导致冠状动脉痉挛和心力衰竭。这是一位早产孕妇的病例，她因严重低钙血症而出现血管痉挛性心绞痛和心电图 QT 间期延长（QTc），这可能是由于医源性高镁血症引起的。她进行了急性冠脉综合征的诊断性检查，但最终通过静脉电解质补充治疗缓解了胸痛和 QTc 延长。这个病例强调了在可能为心脏源性胸痛的鉴别诊断中考虑低钙血症的重要性。
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