Asymptomatic Hypocalcaemia and QT Prolongation in Patients with Chronic Liver Disease

摘要

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 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.