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Severe hypocalcaemia mimicking acute coronary syndrome
  1. Sahitya Allam1,
  2. Ethan Kotloff1,
  3. Anusha Bhat2 and
  4. Libin Wang2
  1. 1Department of Internal Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
  2. 2Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
  1. Correspondence to Dr Sahitya Allam; sahiallam9{at}


Hypocalcaemia is a common electrolyte deficiency that can be found in up to 28% of hospitalised patients. It may affect cardiac and smooth muscle tone, leading to ECG abnormalities and, in rare cases, coronary spasms and heart failure. This is a case of a pregnant woman in preterm labour who developed vasospastic angina and corrected QT interval (QTc) prolongation on ECG from severe hypocalcaemia, which likely occurred due to iatrogenic hypermagnesaemia. She had a negative diagnostic workup for acute coronary syndrome, and her chest pain and QTc prolongation ultimately resolved with intravenous electrolyte repletion. This case highlights the importance of considering hypocalcaemia on the differential of chest pain that is possibly cardiac in origin.

  • Ischaemic heart disease
  • Calcium and bone

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: SA, EK, AB and LW. The following authors gave final approval of the manuscript: AB and LW. Is the patient one of the authors of this manuscript? No.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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