A patient with a decreased or low-normal serum calcium concentration is at increased risk for sudden death.

Mechanism of death: presumably cardiac arrhythmia, possibly associated with prolongation of the QTc


Additional risk factors that may impact risk:

(1) coronary artery disease

(2) cardiomyopathy

(3) heart failure

(4) drug-induced QTc prolongation

(5) other serum electrolyte abnormalities

(6) diabetes mellitus

(7) renal failure

(8) diuretic therapy

(9) COPD


In evaluation of the patient it is important:

(1) to identify the cause(s) of the hypocalcemia

(2) to consider the ionized fraction

(3) to consider measurement of intra-ocular electrolytes if the patient is deceased

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