Key result
Intravenous calcium gluconate followed by oral vitamin D and calcium supplementation successfully normalized the QTc interval from 556 ms to 453 ms and resolved palpitations and presyncope.
Why the study?
Hypocalcaemia due to severe vitamin D deficiency is an uncommon cause of acquired long QT syndrome associated with life-threatening ventricular arrhythmias.
Case Report (n=1)
Severe vitamin D deficiency can cause severe hypocalcemia leading to acquired long QT syndrome, which is reversible with calcium and vitamin D supplementation.
Hypocalcemia from vitamin D deficiency may cause reversible acquired long QT; leaves open need for prospective studies before screening or supplementation changes practice.
Long QT syndrome with Torsades de Pointes (TdP) is a life-threatening polymorphic ventricular arrhythmia. The corrected QT (QTc) prolongation >500 milliseconds (ms) has been associated with TdP. Hypocalcaemia due to severe vitamin D deficiency is an uncommon cause of acquired long QT. We hereby present a case of a 40-year-old woman with sensorineural deafness and having symptoms of palpitations and presyncope. She had a QTc interval of 556 ms (reference range, QTc 451-470 ms in adult healthy woman) on 24-hour Holter analysis. Genetic analysis for congenital long QT syndrome was negative. She was diagnosed with severe hypocalcaemia secondary to severe vitamin D deficiency. After treatment with intravenous calcium gluconate, followed by oral vitamin D and calcium supplementation, the QTc became normalised and no further episode of palpitations or presyncope occurred. The causes of vitamin D deficiency was due to inadequate exposure to sunlight and a strict vegan diet.
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Gupta et al. (2020) conducted a case report in Severe vitamin D deficiency with hypocalcemia and prolonged QTc (n=1). Intravenous calcium gluconate and oral vitamin D/calcium supplementation was evaluated on QTc interval and symptom resolution. Intravenous calcium gluconate followed by oral vitamin D and calcium supplementation successfully normalized the QTc interval from 556 ms to 453 ms and resolved palpitations and presyncope.
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