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Suspected hypercalcemia induced ST-segment elevation in a patient with sarcoidosis

Michael M Braun, Keith Petersen, Sophia Hermann, Erika Overbeek-Wager, Miles Layton, David Trowbridge
Military Medicine 2015, 180 (1): e160-3
Sarcoidosis is a multisystem granulomatous disease that affects 10 to 20 people per 100,000 in the United States. Hypercalcemia is a known side effect of the disease and in rare instances has been shown to cause ST-segment elevation on electrocardiogram testing that mimics myocardial infarction. Herein, we present a rare case of a 55-year-old, asymptomatic African-American male with sarcoidosis and hydrochlorothiazide usage presenting with ST-segment elevation of the anterior leads secondary to hypercalcemia. Urgent cardiac catheterization showed normal coronary arteries without blockage. The patient's hypercalcemia was corrected with intravenous fluids and the ST-segment elevation resolved. The exact mechanism of ST-segment elevation induced hypercalcemia is unknown. Treatment of the underlying cause of the hypercalcemia is the mainstay of therapy.


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