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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The charts were reviewed of more than 200 patients discharged from the hospital between 1972 and 1977 with a diagnosis implying abnormal calcium metabolism. When all other variables known to affect the Q-T interval were eliminated, serum calcium concentrations on 65 occasions in 39 patients were found to correlate significantly (P less than 0.001 or better) with the following electrocardiographic intervals: Q-aTc (beginning of QRS complex to apex of T wave), Q-oTc (beginning of QRS complex to onset of T wave) and Q-Tc (beginning of QRS complex to end of T wave). Of these, the Q-aTc interval was the more easily and precisely measured at elevated calcium levels and exhibited the strongest correlation (P less than 0.0001) over the range of calcium levels measured. The relation was linear and could be used to estimate serum calcium levels from measured Q-aTc intervals. For a Q-aTc interval of 0.29 second or less (range 0.23 to 0.29) the serum calcium was estimated to +/- 1.9 mg/dl with 95 percent confidence. For a Q-aTc interval of 0.27 second or less, the correspondence with hypercalcemia in the study series was 90 percent or better. When all other factors known to affect the Q-T interval are ruled out, the shortening of the Q-aTc interval appears to be a useful clinical indicator of hypercalcemia.
Am J Cardiol 1979 Aug
PMID:Q-aTc interval as a clinical indicator of hypercalcemia. 46 62

It has been investigated whether calcium- and verapamil-dependent sensitivities of carotis baroreceptors also exist in man. To answer this question, we pre- and postoperatively measured changes in heart rate during carotid sinus stimulation before and after intravenous administration of 5 mg verapamil in 23 patients with primary hyperparathyroidism. Findings during hypercalcemia were as expected: a more pronounced reduction of heart rate at comparatively low calcium levels. During normocalcemia, we found an opposite effect: a more pronounced reduction at relatively high calcium levels, which was statistically significant. This fact could be explained according to our interpretation. In previous reports, local effects on baroreceptors were examined, whereas we measured the combined effect of several calcium actions. As expected, verapamil attenuated the decrease in heart rate which, however, was not statistically significant.
Basic Res Cardiol
PMID:Changes in heart rate by verapamil during carotid sinus stimulation in patients with hyperparathyroidism, pre- and postoperatively. 146 30

Four case reports are presented which illustrate various patterns of calcific deposits in the heart. Valvular, myocardial, intracavitary, and coronary calcific deposits are illustrated, with emphasis on pathology and clinicopathologic-radiologic correlation. "Dystrophic" and "metastatic" calcifications are terms used to describe calcific deposits in abnormal and normal soft tissues, respectively. These terms are somewhat confusing in relation to the myocardium, however, as the chronologic sequence of cardiac injury is often uncertain. We suggest that these terms be avoided in relation to the heart, in favor of simple descriptive terms such as "myocardial calcific deposits." Many conditions, such as renal failure and hypercalcemia may contribute to the likelihood of soft tissue calcification, although a definite common etiology has not been identified. Likewise, soft tissue calcification has been difficult to diagnose premortem. The advent of ultrafast (cine) computed tomography may provide a quick, noninvasive, highly sensitive and specific method for diagnosis of soft tissue calcific deposits in the future.
Clin Cardiol 1990 Apr
PMID:Calcific deposits in the heart. 235 Sep 14

Reliability of corrected QT intervals (QoTc, QaTc, and QeTc) as indicators of clinical hypercalcemia was assessed in 14 hypercalcemic patients. Hypercalcemia was severe to extreme (serum calcium 14.9 to 22.8 mg/dl) in 11, moderate (13.4 mg/dl) in 1, and mild (12.2 and 11.8 mg/dl) in 2 patients. QT intervals during hypercalcemia were compared with those during normocalcemia either before or after development of hypercalcemia. QeTc interval showed neither significant correlation with serum calcium nor any consistent pattern of change with development of hypercalcemia or normalization of serum calcium. In contrast, QoTc and QaTc intervals shortened with development of hypercalcemia and returned toward normal with normalization of serum calcium in all the patients, and showed significant correlation with serum calcium (QoTc: r = -0.77, p less than 0.001, n = 35; QaTc: r = 0.82, p less than 0.001, n = 35). QaTc was short (less than 0.30 s) in all the ECGs in severe and moderate hypercalcemia and in 2 of the 5 ECGs in mild hypercalcemia. Combination of short QoTc (less than 0.18 s) and short QaTc was found to be highly specific for, and was present in 65% of ECGs, in moderate and severe hypercalcemia. Combination of normal QoTc (greater than 0.18 s) and normal QaTc (greater than 0.30 s) was not observed in moderate or severe hypercalcemia. We conclude that QoTc and QaTc intervals are reliable indicators of clinical hypercalcemia.
Clin Cardiol 1988 Jun
PMID:Reliability of QT intervals as indicators of clinical hypercalcemia. 289 66

A series of experiments was undertaken to assess the effects of calcium administration, in vivo, on renin and aldosterone secretion. In the anesthetized dog, renin secretion was decreased by renal arterial infusions of calcium chloride and calcium gluconate; aldosterone excretion was not affected. In the sodium chloride-deprived rat, dietary calcium chloride loading decreased plasma renin activity, whereas calcium gluconate did not. Both calcium salts increased aldosterone production. In the non-filtering, denervated, papaverine-treated dog kidney, renin release was stimulated by renal arterial infusion of verapamil. In the rat, chronic oral verapamil administration decreased plasma aldosterone but had no effect on renin. In humans, chronic oral verapamil decreased aldosterone responsiveness to infusion of angiotensin II. Thus, in vivo renin release is inhibited by hypercalcemia and stimulated by blocking calcium transport; conversely, aldosterone production is stimulated by a high calcium intake and inhibited by blocking calcium transport. These effects of calcium on renin and aldosterone may have implications for understanding the putative relation between calcium and hypertension.
Am J Cardiol 1988 Oct 05
PMID:Effects of calcium on renin and aldosterone. 305 94

The relationship between QT interval and serum calcium concentration (s-Ca) was examined in 9 hypercalcemic (s-Ca greater than 11 mg/dl) patients. Three QT intervals corrected by Bazett's formula were used for the analysis: the intervals from the beginning of the QRS to the onset (QoTc), the apex (QaTc), and the end of T wave (QeTc). The measurements of s-Ca and other electrolytes were made on the blood sample taken on the same day of the electrocardiogram (ECG) recordings. The normal range of s-Ca and three QTc intervals was determined in 50 outpatients with no cardiac disease. Three QT intervals in the hypercalcemic patients were significantly shortened with a diminution in the s-Ca. The QTc intervals showed significant negative correlation with s-Ca. Sensitivity of QoTc, QaTc, and QeTc in predicting high s-Ca was 83%, 57%, and 39%, respectively, and specificity was 100%, 100%, and 89%. The PQ interval tended to be prolonged in the case of hypercalcemia, but the change was statistically insignificant. These observations suggest that QT intervals can serve as an indicator of high s-Ca and that the QoTc seems to be a good indicator of the three QTc's.
Clin Cardiol 1988 Feb
PMID:QT intervals as an index of high serum calcium in hypercalcemia. 334 8

We report the case of a 50-year-old female suffering from angina pectoris with a positive exercise test and normal coronary arteriography. Nifedipine relieved the angina. Laboratory tests demonstrated hypercalcaemia and led to a diagnosis of parathyroid adenoma. Surgical removal of the adenoma resulted in normalization of calcaemia and, during 4-year follow-up, she has had no angina. Two exercise tests in this period were negative.
Int J Cardiol 1988 May
PMID:Primary hyperparathyroidism and angina pectoris. 337 88

Diuretics have found wide application in critical care medicine. The use of mannitol and loop diuretics in a variety of life-threatening disorders is reviewed. The combined venodilatory and natriuretic effects of bumetanide, furosemide and ethacrynic acid relieve congestive symptoms in pulmonary edema. Although commonly administered to prevent development of acute tubular necrosis or in varying stages of evolving disease, few data are available to demonstrate the efficacy of mannitol or loop diuretics. An approach to the oliguric patient with acute tubular necrosis is described. The dangers of hyponatremia are reviewed, and the rational use of loop diuretics and hypertonic saline is outlined. The 3 loop-active agents inhibit calcium reabsorption in the thick ascending limb of Henle's loop and therefore have proved useful in treating hypercalcemia. A practical approach to the diuretic-saline treatment of severe hypercalcemia is outlined. The kaliuretic effect of loop diuretics can be used to advantage in patients with acute or chronic hyperkalemia. A guide to such therapy is described.
Am J Cardiol 1986 Jan 24
PMID:Diuretic use in critical care. 351 55

A 19-year-old male was found to have combined supravalvular aortic stenosis and hypertrophic subaortic stenosis. Two possible hypotheses with supportive evidence in the literature may explain this association: (1) long-standing fixed supravalvular aortic stenosis may result in secondary hypertrophic subaortic stenosis, and (2) infantile hypercalcemia, a condition closely related to supravalvular aortic stenosis, may also be involved by continuous inotropic stimulation in the pathogenesis of muscular hypertrophy and subaortic stenosis of the left ventricle. We tend to favor the second theory in light of recent evidence in the literature.
Clin Cardiol 1982 Oct
PMID:Combined supravalvular aortic stenosis and hypertrophic subaortic stenosis: coexistence or association? 689 Aug 85

To investigate the effect of nifedipine on hypercalcemic electrocardiographical alterations, steadily increasing hypercalcemia was induced in guinea-pigs by continuous calcium gluconate infusion until cardiac arrest occurred. During the experimental time the electrocardiograms were continuously recorded and compared in animals with and without pretreatment by nifedipine (Adalat). The hypercalcemia-induced electrocardiographical alterations intensified during increasing serum calcium levels. Ascending serum potassium and magnesium levels indicated increasing cell damage with a leak of these mainly intracellular ions. Pretreatment by nifedipine did not significantly influence the hypercalcemia-induced bradycardia and augmentation of the P-Q interval except a small and transient effect during relatively low calcium levels. The drug, however, exerted a distinct normalizing effect on hypercalcemic reduction of the S-T segment and the Q-T interval despite of an unaltered development of hypercalcemia. Accordingly, the cellular potassium and magnesium leaks were markedly reduced and the survival time during calcium infusion was significantly prolonged after nifedipine pretreatment. These electrophysiological data are in agreement with our previous cytochemical studies, which showed a protective effect of nifedipine against hypercalcemia-induced overloading of the cellular calcium depots in myocardial cells. Whether this cardio-protective effect of nifedipine during hypercalcemia can be used therapeutically in hypercalcemic crisis, has to be examined in clinical studies.
Basic Res Cardiol
PMID:Electrocardiographic evidence for a cardioprotective effect of nifedipine during experimental hypercalcemia. 707 50


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