Irtza Ali, Waseem Ahmed, Uzma Sajjad.
Incidence of asymptomatic hypocalcaemia and qt prolongation in patients with chronic liver disease.
J Cardiovascular Dis Jan ;12(1):5-8.

BACKGROUND: Chronic hypocalcaemia can occur in patients of chronic liver disease (CLD) due to Vitamin D dependent metabolism of calcium. Chronic asymptomatic hypocalcaemia usually goes unnoticed in such patients. However, it can cause significant QT prolongation, which is a significant marker for sudden cardiac death due to ventricular arrhythmias. OBJECTIVE: To study patients with CLD and find out the incidence of asymptomatic but significant hypocalcaemia, causing QT prolongation on ECG and thus predisposing the patients at increased risk of sudden cardiac death. MATERIAL AND METHODS: It was a descriptive, cross-sectional study of six months duration conducted in Jinnah Hospital, Lahore from September, 2014 to February, 2015. A total of 165 indoor and outdoor Chronic Liver Disease patients were evaluated. Data was recorded and analyzed by SPSS version 16.0 RESULTS: Out of 165 patients with End-stage CLD, hypocalcaemia causing QT prolongation was found in 62(37.5%) patients. While hypocalcaemia, without any significant QT prolongation, was seen in 78(47.2%) patients. CONCLUSION: In this study we found that asymptomatic hypocalcaemia causing significant QT prolongation is a serious but often unnoticed adverse event in patients having CLD. It can lead to ventricular arrhythmias and can significantly contribute to mortality in such patients. Thus, an effort should be made to recognize significant hypocalcaemia and QT prolongation, even if asymptomatic, so that measures can be taken to correct the calcium levels and QT interval to avoid mortality due to these factors.

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