Severe hypercalcaemia can lead to reversible complete heart block without QT interval shortening.
May warrant calcium check in unexplained heart block; hypothesis-generating case extending sparse reports but needs prospective validation.
A 65-year-old woman presented to the emergency room with a syncope. An ECG done revealed complete heart block with a narrow QRS escape rhythm and a normal QT interval. Further investigation revealed severe hypercalcaemia and elevated parathormone levels. Her heart block disappeared on correction of the hypercalcaemia. A right inferior parathyroid adenoma was found and surgically removed. Thus, hypercalcaemia may lead to reversible complete heart block without QT interval shortening.
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Ramakumar et al. (2021) studied this question.
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