Hypercalcemia Due to Vitamin D Intoxication with Clinical Features Mimicking Acute Myocardial Infarction

Naoto ASHIZAWA; Syuji ARAKAWA; Yuji KOIDE; Genji TODA; Shinji SETO; Katsusuke YANO

doi:10.2169/internalmedicine.42.340

Naoto ASHIZAWA, Syuji ARAKAWA, Yuji KOIDE, Genji TODA, Shinji SETO, Katsusuke YANO

Author information

Naoto ASHIZAWA
The Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
Syuji ARAKAWA
The Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
Yuji KOIDE
The Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
Genji TODA
The Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
Shinji SETO
The Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
Katsusuke YANO
The Division of Cardiovascular Medicine, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University

Keywords: electrocardiogram (ECG), QaTc interval, hypercalcemia, vitamin D intoxication, acute myocardial infarction

JOURNAL FREE ACCESS

2003 Volume 42 Issue 4 Pages 340-344

DOI https://doi.org/10.2169/internalmedicine.42.340

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Abstract

We report a case of hypercalcemia in an elderly patient due to vitamin D intoxication with clinical features and electrocardiogram (ECG) findings mimicking acute myocardial infarction. A 78-year-old man was referred to our department with symptoms of general fatigue, anorexia and chest pain. The ECG demonstrated ST elevation in leads V₁ to V₃ and diffuse T wave flattening, resulting in myocardial infarction being suspected. However, his symptoms, including chest pain, gradually improved and the ECG returned to normal in accordance with a fall in his serum calcium level. We introduce the use of QaTc interval shortening in differentiating ST-T changes of hypercalcemia from those of true myocardial ischemia.
(Internal Medicine 42: 340-344, 2003)

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