Hypercalcaemia and a short QT interval

John, Thadathilankal-Jess; John, Kiran; Rensburg, Rene Jansen van; Kyriakakis, Charles

doi:10.1093/qjmed/hcz109

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…First, it demonstrates the challenges around symptom recognition particularly in patients presenting with cardiac abnormalities which can lead to underdiagnosis and delays in treatment. The most common ECG findings of hypercalcaemia are a shortened ST segment, reduced QT interval, varying degrees of heart block and ventricular conduction defects 16 17. However, arrhythmias are uncommon with only one case of ventricular bigeminy secondary to a parathyroid adenoma previously reported 14.…”

Section: Discussionmentioning

confidence: 99%

Parathyroid carcinoma presenting with ventricular bigeminy in pregnancy

2022

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Parathyroid carcinoma is very rare in pregnancy. Clinical features are similar to primary hyperparathyroidism. A 38-year-old pregnant woman had repeated hospital admissions for palpitations, headaches, dizziness and polydipsia. Blood investigations showed severe hypercalcaemia with raised parathyroid hormone and 24-hour ECG showed ventricular bigeminy and premature ventricular contractions. Neck ultrasound showed a lesion in the right thyroid lobe. Consequently, she underwent an en bloc resection of the right parathyroid and thyroid lobe at 23 weeks gestation. Histology results confirmed parathyroid cancer. This case highlights the complexities of identifying hypercalcaemia in pregnancy due to the overlapping features with common disorders of pregnancy. Early recognition and timely surgical management can prevent maternal and fetal complications. Also, the case demonstrates the value of interprofessional collaboration between different specialities in providing quality care and improving outcomes. An abridged version of this case was presented at European Congress of Endocrinology 2021.

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Section: Discussionmentioning

confidence: 99%

Parathyroid carcinoma presenting with ventricular bigeminy in pregnancy

2022

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Primary Hyperparathyroidism Is Associated With Shorter QTc Intervals, but Not Arrhythmia

Stewart

Steinl

Huang

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Primary hyperparathyroidism (PHPT) is associated with subclinical cardiovascular disease, but data regarding cardiac conduction abnormalities are limited. Objective and Design Retrospective cross-sectional comparison of cardiac conduction in patients with PHPT or thyroid disease (TD). Participants and Setting Patients ≥40 years old who underwent parathyroidectomy or thyroidectomy at a single tertiary institution from 2013-2018. Methods and Outcomes Demographics and pre-operative electrocardiogram (EKG) parameters were compared using the Mann-Whitney U, Chi Square tests, and linear regression. Results A total of 1,242 patients were included: 49.8% PHPT (n=619) and 50.2% TD (n=623). Median age was 60.5 years (IQR 53.6-67.9). Compared to controls, PHPT patients had higher median serum calcium [10.7 mg/dL (IQR 10.4-11.1) vs 9.5 mg/dL (IQR 9.3-9.8), p<0.001] as expected, as well as, a higher prevalence of hyperlipidemia (49% vs 36%, p<0.001) and hypertension (50.1% vs 42.2%, p<0.01). Based on EKG, there was no difference in PR interval or the prevalence of arrhythmia, atrioventricular block, ST segment/T wave changes, premature ventricular complexes, right bundle branch block or left bundle branch block after adjusting for covariates. The PHPT group had a lower mean corrected QT interval (414ms (+/- 24) vs 422ms (+/- 24), p<0.01), adjusted for covariates. Serum calcium predicted QTc independently of age, sex, and other covariates. Conclusions In the largest study to date, PHPT patients had shorter QTc intervals compared to TD controls, but no increased prevalence of arrhythmia based on pre-operative EKG.

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Hypercalcaemia and a short QT interval

Cited by 2 publications

References 5 publications

Parathyroid carcinoma presenting with ventricular bigeminy in pregnancy

Parathyroid carcinoma presenting with ventricular bigeminy in pregnancy

Primary Hyperparathyroidism Is Associated With Shorter QTc Intervals, but Not Arrhythmia

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