{"id":18176,"date":"2014-12-02T10:05:53","date_gmt":"2014-12-02T10:05:53","guid":{"rendered":"https:\/\/cardiophile.org\/?p=18176"},"modified":"2023-01-12T14:08:51","modified_gmt":"2023-01-12T08:38:51","slug":"ecg-changes-in-hypocalcemia-mechanism","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ecg-changes-in-hypocalcemia-mechanism\/","title":{"rendered":"ECG changes in hypocalcemia &#8211; Mechanism"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/5_7elvxVHLk\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">ECG changes in hypocalcemia &#8211; Mechanism<\/span><\/h2>\n<p class=\"p1\"><span style=\"color: #0000ff;\">Prolongation of ST segment contributing to prolonged QT interval and corrected QT interval is the hallmark ECG change in hypocalcemia<\/span>. Hypocalcemia prolongs phase 2 of the myocardial action potential, thereby prolonging the ST segment. T waves are not generally affected in hypocalcemia because phase 3 of the myocardial action potential is not affected by calcium ions. Calcium channels close at the end of phase 2, with phase 3 being mostly related to potassium channel activity.<\/p>\n<p class=\"p1\">Cases are on record in which severe hypocalcemia has mimicked ST elevation myocardial infarction in the emergency department. Coronary angiography showed patent coronary arteries and ECG changes reverted after correction of hypocalcemia with calcium supplementation.<sup>1<\/sup><\/p>\n<p class=\"p1\">Associated electrolyte abnormalities can alter the ECG findings of hypocalcemia as occurs in renal failure, in which hypocalcemia is often associated with hyperkalemia. Yet intravenous calcium which is often given for treatment of hyperkalemia in acute renal failure is useful in treatment of associated hypocalcemia as well.<\/p>\n<p class=\"p1\">It may be noted that half of the serum calcium is bound to plasma proteins, of which 80% is bound to albumin. 5 to 10% of the calcium is bound to plasma anions like phosphates and citrates. Only about half of the calcium is in the ionized form with physiological activity. Ionized calcium can be reduced in alkalosis as alkalosis enhances calcium binding to albumin.<\/p>\n<p class=\"p1\"><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li class=\"p1\">Ilveskoski E, Sclarovsky S, Nikus K. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21129889\">Severe hypocalcemia simulating ST-elevation myocardial infarction<\/a>. Am J Emerg Med. 2012;30:256.e3-6.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>ST segment prolongation without changes in the T wave is the hallmark of hypocalcemia. ECG changes and clinical features of hypocalcemia are due to lowering of ionized calcium which is usually about half of the serum calcium.<\/p>\n","protected":false},"author":1,"featured_media":58078,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6],"tags":[],"class_list":["post-18176","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECG changes in hypocalcemia - Mechanism<\/title>\n<meta name=\"description\" content=\"ECG changes in hypocalcemia - Mechanism: Prolongation of ST segment contributing to prolonged QT interval and corrected QT interval (QTc).\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-changes-in-hypocalcemia-mechanism\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECG changes in hypocalcemia - Mechanism\" \/>\n<meta property=\"og:description\" content=\"ECG changes in hypocalcemia - Mechanism: Prolongation of ST segment contributing to prolonged QT interval and corrected QT interval (QTc).\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ecg-changes-in-hypocalcemia-mechanism\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2014-12-02T10:05:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-01-12T08:38:51+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2014\/12\/ECG-changes-in-hypocalcemia.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"893\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-changes-in-hypocalcemia-mechanism\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-changes-in-hypocalcemia-mechanism\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"ECG changes in hypocalcemia &#8211; 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