A patient with a decreased or low-normal serum calcium concentration is at increased risk for sudden death.
Mechanism of death: presumably cardiac arrhythmia, possibly associated with prolongation of the QTc
Additional risk factors that may impact risk:
(1) coronary artery disease
(2) cardiomyopathy
(3) heart failure
(4) drug-induced QTc prolongation
(5) other serum electrolyte abnormalities
(6) diabetes mellitus
(7) renal failure
(8) diuretic therapy
(9) COPD
In evaluation of the patient it is important:
(1) to identify the cause(s) of the hypocalcemia
(2) to consider the ionized fraction
(3) to consider measurement of intra-ocular electrolytes if the patient is deceased
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Specialty: Clinical Laboratory, Endocrinology
