Lab Medicine Edition | Electrolytes: Calcium (Hypercalcemia, Hypocalcemia)
Apr 18, 2024
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Mira T. Keddis, M.D., a specialist in calcium disorders, shares her expertise on managing hypercalcemia and hypocalcemia. She discusses the clinical significance of calcium levels on neuromuscular and cardiac health. Delving into hypercalcemia, she explains its causes and effects, especially in cancer patients. The conversation covers how thiazide diuretics influence calcium levels and the importance of precise thresholds for treatment decisions. Discover the careful balance of hormones and risks in calcium management that can impact patient outcomes.
Hypercalcemia can lead to severe complications like kidney injury and arrhythmias, necessitating careful assessment and management by healthcare providers.
Hypocalcemia symptoms require cautious evaluation, particularly regarding vitamin D deficiency and potential neuromuscular excitability, before initiating treatment strategies.
Deep dives
The Importance of Calcium Management
Calcium disorders are significant in healthcare, with hypercalcemia and hypocalcemia posing serious risks if not managed correctly. Calcium plays a crucial role in neuromuscular function and cardiac activity; thus, disruptions can lead to potentially life-threatening complications such as arrhythmias. It’s vital for healthcare providers to understand that calcium is largely stored in the bones, with only a small percentage circulating in the blood. Accurate assessment of calcium levels and their implications requires considering factors such as total calcium, ionized calcium, and the patient's albumin levels.
Recognizing and Understanding Hypercalcemia
Hypercalcemia is often associated with several key causes, including malignancies and parathyroid abnormalities, which necessitate different diagnostic approaches. Symptoms can include abdominal pain, constipation, and altered mental status, often remembered through the mnemonic 'moans, groans, and psychic overtones'. Healthcare providers must recognize hypercalcemia's potential to induce kidney injury, which can arise from calcium's vasoconstrictive effects, further complicating patient management. Following initial assessment, evaluating parathyroid hormone and vitamin D levels is essential to guide subsequent treatment decisions.
Addressing Hypocalcemia and Its Impacts
Hypocalcemia can exhibit distinctive physical signs, such as Trousseau's and Chvostek's signs, indicating neuromuscular excitability issues. Vitamin D deficiency is a common cause of low calcium levels, often resulting from malabsorption or dietary insufficient intake. Providers should not rush to treat all cases of hypocalcemia, especially in patients with renal failure, as symptomatic cases require more immediate intervention. The management of hyperphosphatemia is also crucial since elevated phosphorus often contributes to lowered calcium levels, making a comprehensive approach to calcium and phosphorus homeostasis necessary in treatment strategies.
Join our host, Andy J. Herber, P.A.-C. to take a deeper look at hypercalcemia and hypocalcemia. This podcast will do a review of the management of calcium disorders with guest, Mira T. Keddis, M.D.