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Malignant prolongation of the QTc interval due to severe vitamin D deficiency: an unusual presentation
  1. Preeti Gupta1,
  2. Sourabh Agstam1,
  3. Ashutosh Yadav2 and
  4. Soumitra Ghosh3
  1. 1Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India
  2. 2Cardiology, Fortis Hospital Mohali, Mohali, Punjab, India
  3. 3Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Soumitra Ghosh; soumitra183{at}


Long QT syndrome with Torsades de Pointes (TdP) is a life-threatening polymorphic ventricular arrhythmia. The corrected QT (QTc) prolongation >500 milliseconds (ms) has been associated with TdP. Hypocalcaemia due to severe vitamin D deficiency is an uncommon cause of acquired long QT. We hereby present a case of a 40-year-old woman with sensorineural deafness and having symptoms of palpitations and presyncope. She had a QTc interval of 556 ms (reference range, QTc 451–470 ms in adult healthy woman) on 24-hour Holter analysis. Genetic analysis for congenital long QT syndrome was negative. She was diagnosed with severe hypocalcaemia secondary to severe vitamin D deficiency. After treatment with intravenous calcium gluconate, followed by oral vitamin D and calcium supplementation, the QTc became normalised and no further episode of palpitations or presyncope occurred. The causes of vitamin D deficiency was due to inadequate exposure to sunlight and a strict vegan diet.

  • arrhythmias
  • pacing and electrophysiology
  • endocrine system
  • calcium and bone
  • medical education

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  • PG and SA are joint first authors.

  • Twitter @DrSoumitraGhos1

  • PG and SA contributed equally.

  • Contributors PG and SA managed the patient. AY collected the data. SG wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.