Hypercalcemia electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Most common finding on ECG due to hypercalcemia is short QT interval.

Findings on ECG are due to hypercalcemia and includes:^[1]^[2]

QT interval – Short QT interval is seen in pateints if hypercalcemia.
ST segment – ST segment is short in patients with hypercalcemia when compared to normocalcemic patients. This represents a decrease in systolic interval.
QRS complex – QRS complex has an increased amplitude in patients with hypercalcemia when compared to normocalcemic patients. This represents an increase in ventricular muscle mass.
T wave – T wave is prolonged in patients with hypercalcemia when compared to normocalcemic patients.

Note: Severe hypercalcacemia may mimic acute myocardial infarction.^[3]

↑ Lind L, Ljunghall S (1994). “Serum calcium and the ECG in patients with primary hyperparathyroidism”. J Electrocardiol. 27 (2): 99–103. doi:10.1016/S0022-0736(05)80092-5. PMID 8201301.
↑ Kelwade JV, Modi KD, Kumar N, Parekh H (2016). “Hypercalcemia and electrocardiogram changes”. Indian J Endocrinol Metab. 20 (6): 892–893. doi:10.4103/2230-8210.192900. PMC 5105587. PMID 27867906.
↑ Wesson LC, Suresh V, Parry RG (2009). “Severe hypercalcaemia mimicking acute myocardial infarction”. Clin Med (Lond). 9 (2): 186–7. PMID 19435131.