Mian Sajjad Ahmad, Nauman Dawood, Zafar Iqbal, Rabia Nazim, Sajid Abaidullah, Shahzad Hussain.
Asymptomatic Hypocalcaemia and QT Prolongation in patients with Chronic Liver Disease.
Ann King Edward Med Uni Jan ;26(2):374-8.

Background: Prolonged low levels of calcium in blood is a common finding in patients having longstanding liver disease as breakdown, degradation and digestion of calcium is related to stores of Vitamin D in body. Among these patients long-standing low stores of calcium remains ignored because of absence of any symptoms. Objective: To assess the frequency of hypocalcaemia and QT prolongation among patients presenting with chronic liver disease in a tertiary care hospital Methods: It was an observational cross-sectional study. It was carried out in North Medical Ward, Department of Medicine Mayo Hospital Lahore from 15-08-2017 to 15-04-2018. 110 patients fulfilling the selection criteria were enrolled. Blood sample were drawn and examined in the hospital Laboratory for evaluation of calcium levels. If levels were <8.8mg/dL, then hypocalcaemia was labeled. ECG was done to assess QT interval. If QT>460ms, then QT prolongation was labeled. All data was noted on proforma. Data was analyzed using SPSS version 20. Results: The mean age of patients was 46.45±8.67 years. There were 44(40%) males and 66(60%) females. The mean BMI of patients was 22.73±4.25kg/m2. The mean duration of CLD was 7.09±3.42years. The mean calcium level of patients was 7.70±1.48mg/dl. In this study, 73(66.4%) patients had hypocalcaemia while 29(26.4%) patients had prolonged QT. The hypocalcaemia causing QT prolongation was found in 24(21.8%) patients. Conclusion: As far as current study is concerned low serum calcium levels are reason for remarkable QT prolongation and this is a grave situation. Due to absence of any symptoms or adverse reactions this condition goes on without coming into notice. But as far as its consequences are concerned it can become a reason for ventricular arrhythmias and remarkably can play a role in increased death rate of affected individuals. So we should try our best to identify extraordinary low levels of calcium and QT prolongation, though presenting without symptoms , if successful in doing so low levels of calcium and prolonged QT interval could be corrected at initial stages and this will directly decrease both morbidity and mortality.

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