The main finding is prolonged QT interval.

Use Bazett formula to calculate QTc. In this case 516 msec

QTc is prolonged if:

• > 440ms in men
• > 460 ms in ladies
• > 500 ms – significant risk of TdP
• < 350 ms – short QT

Causes for QT prolongation:

• Hypo K
• Hypo Ca
• Hypo Mg
• Hypo T
• Myocardial ischaemia
• Raised ICP
• Congenital
• Medications, drugs

In this case it is due to hypocalcaemia, as  TW are unchanged.

Causes for hypocalcaemia:

• Hypoparathyroidism
• Vit d deficiency
• Acute pancreatitis
• Low PO4
• Low Mg
• Diuretics
• Congenital disorders – Di George  syndrome
• Critical illness – sepsis

Symptoms:

• Neuromascular excitability
• Carpopedal spasm
• Tetany
• Chvostek sign
• Trousseau sign
• Seizures

Svetlana