{"id":616,"date":"2016-07-24T00:01:27","date_gmt":"2016-07-24T00:01:27","guid":{"rendered":"http:\/\/torreyekg.com\/?p=616"},"modified":"2016-07-09T18:27:44","modified_gmt":"2016-07-09T18:27:44","slug":"ekg-of-the-week-38","status":"publish","type":"post","link":"https:\/\/torreyekg.com\/index.php\/2016\/07\/24\/ekg-of-the-week-38\/","title":{"rendered":"EKG of the Week #38"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/381.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-617\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/381.png\" alt=\"381\" width=\"647\" height=\"354\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/381.png 647w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/381-300x164.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><br \/>\n76-year-old man with squamous cell cancer of the oropharynx presents with lethargy and confusion.<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Answer &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\"><br \/>\nSinus at 75\/minute<br \/>\nAxis normal, PR and QRS also normal<br \/>\nQT interval is visibly shorter than normal<br \/>\nNo LVH<br \/>\nNo ischemia or infarct patterns\n<p>A decrease in QT interval is seen with hypercalcemia, which fits with the patient\u2019s presentation and known malignancy. This gentleman\u2019s ionized calcium was 2.2.<\/p>\n<p>The ST-segment is short or absent in hypercalcemia and the duration of the QTc interval is decreased. Although it is difficult to give an absolute QTc interval below which hypercalcemia is assured, this value is always\u00a0&lt;400ms and visually fairly obvious.<\/p>\n<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/382-1.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-621\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/382-1.png\" alt=\"382\" width=\"431\" height=\"181\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/382-1.png 431w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/382-1-300x126.png 300w\" sizes=\"auto, (max-width: 431px) 100vw, 431px\" \/><\/a><br \/>\nAnother occasional EKG presentation of hypercalcemia is leftward movement of the apex of the T-wave as in the above example, another example of hypercalcemia associated with malignancy.<\/p>\n<p>Diercks D, et al. Electrocardiographic manifestations: electrolyte abnormalities. J Emerg Med 27:153-160, 2004.<br \/>\n<\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>76-year-old man with squamous cell cancer of the oropharynx presents with lethargy and confusion.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-616","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/616","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=616"}],"version-history":[{"count":3,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/616\/revisions"}],"predecessor-version":[{"id":622,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/616\/revisions\/622"}],"wp:attachment":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=616"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=616"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}