Severe hypocalcemia simulating ST-elevation myocardial infarction |
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Authors: | Ilveskoski Erkki Sclarovsky Samuel Nikus Kjell |
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Affiliation: | Department of Cardiology, Tampere University Hospital Heart Center, PO Box 2000, FI-33521 Tampere, Finland Medical School, University of Tampere, Tampere, Finland; Tel Aviv University, Tel Aviv, Israel; Department of Cardiology, Tampere University Hospital Heart Center, PO Box 2000, FI-33521 Tampere, Finland |
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Abstract: | ST-elevation myocardial infarction (STEMI) is an emergency situation in which immediate measures for myocardial reperfusion are needed. The diagnosis is based on the recognition of ST-segment elevation in the electrocardiogram (ECG). In case of coronary artery occlusion, ST-segment elevation is caused by an injury current from the ischemic myocardium. Rarely, other mechanisms may lead to ECG changes mimicking STEMI. In our case, a 65-year-old man was presented to our institution with ECG abnormalities suggestive of STEMI. However, coronary angiography showed open arteries. Laboratory tests revealed severe hypocalcemia caused by a deficiency of vitamin D. After calcium replacement therapy, the ECG normalized, and the patient was discharged in good condition. Only a few case reports on hypocalcemia-induced ST-segment elevation exist, and the mechanism remains unknown. |
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