Hypocalcemia history and symptoms

Clinical presentation of hypocalcemia reflects the serum level of ionized calcium and depends on the severity of any concurrent electrolyte imbalance. Overt symptoms occur when ionized calcium falls below 3.2 mg/dL (0.8 mmol/L). An abrupt fall in the serum calcium level typically manifests as neuromuscular hyperexcitability in the form of tetany and tingling. Patients who develop hypocalcemia gradually may be asymptomatic. In addition to fatigue and muscle weakness, longstanding hypocalcemia is usually associated with neuropsychiatric symptoms.

The majority of patients with mild hypocalcemia are asymptomatic

Common symptoms of hypocalcemia include:^[1][2][3][4]

Neuromuscular symptoms

• Tetany: which is hallmark of acute hypocalcemia
• Paresthesias or tingling
• Muscle spasms: Muscle twitching and cramping

• Laryngeal or bronchial spasm

• Anxiety
• Hallucinations
• Confusion
• Irritability

• Bradycardia
• Ventricular arrhythmias
• Congestive heart failure

• Laryngeal stridor
• Bronchospasm

Less common symptoms of hypocalcemia include^[5]

• Cognitive deficits
• Extrapyramidal symptoms
• Dermatitis
• Dry skin
• Brittle nails

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