Digoxin, hypercalcaemia, and cardiac conduction

The cardiac effects of hypercalcaemia are usually manifest as a shortening of the QT-interval. Hypercalcaemia is infrequently associated with a clinically manifest arrhythmia. However, concomitant therapy with digoxin or underlying cardiac disease can potentiate the arrhythmogenic effects of hyperca...

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Bibliographic Details
Published in:Postgraduate medical journal 1999-09, Vol.75 (887), p.554-556
Main Authors: Vella, Adrian, Gerber, Thomas C, Hayes, David L, Reeder, Guy S
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anti-Arrhythmia Agents - adverse effects
Biological and medical sciences
Bradycardia - etiology
Bronchial Neoplasms - complications
Carcinoma, Squamous Cell - complications
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiology. Vascular system
Cardiomyopathy
Cardiovascular disease
Chemotherapy
Contraindications
Digoxin - adverse effects
Electrocardiography
Female
Heart
Heart failure
Humans
Hypercalcemia - complications
Medical sciences
Postoperative period
Short Report
Sinuses
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Summary:The cardiac effects of hypercalcaemia are usually manifest as a shortening of the QT-interval. Hypercalcaemia is infrequently associated with a clinically manifest arrhythmia. However, concomitant therapy with digoxin or underlying cardiac disease can potentiate the arrhythmogenic effects of hypercalcaemia, leading to a symptomatic rhythm disorder. We describe a symptomatic arrhythmia, which developed in a patient with hypercalcaemia secondary to squamous cell carcinoma of the bronchus. The patient was on digoxin therapy at the time. The arrhythmia did not recur after discontinuation of digoxin therapy and correction of the hypercalcaemia. Because of its effect on cardiac conduction, hypercalcaemia should be considered in the evaluation of any patient with an unexplained bradyarrhythmia. Conversely, patients with hypercalcaemia should discontinue digoxin therapy and be evaluated for the presence of rhythm disorders while receiving appropriate treatment for hypercalcaemia.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.75.887.554