Severe hypocalcemia mimicking acute inferior ST-segment elevation myocardial infarction

Abstract

We report the case of a 52-year-old gentleman, admitted to the medical intensive care unit with multiple organ system dysfunction due to acute severe pancreatitis. He was found to have severe hypocalcemia, bradycardia and an electrocardiogram (EKG) showing ST-segment elevation in infero-lateral leads. The patient was treated with intravenous calcium gluconate with prompt improvement of heart rate and reversal of EKG changes. Subsequent evaluation for myocardial ischemia was negative. We believe the EKG changes mimicking acute ST-segment elevation myocardial infarction were due to severe hypocalcemia. To our knowledge this is very rare occurrence.