Calcium Low ( Hypocalcemia ) : Acute Management

Hypocalcemia refers to an abnormally low level of calcium in the blood, which can be a life-threatening condition requiring urgent treatment, especially in acute cases. Calcium plays a crucial role in various physiological processes, including muscle contraction, nerve function, and blood clotting. When serum calcium levels fall below 1.9 mmol/L, symptoms of hypocalcemia typically manifest, although the exact threshold can vary based on the rapidity of the decline.

Common clinical signs include peri-oral numbness, muscle spasms (tetany), and positive Trousseau’s and Chvostek’s signs. In more severe cases, patients may present with seizures, laryngospasm, and cardiac arrhythmias (notably a prolonged QT interval on ECG). Acute hypocalcemia is often triggered by surgical disruption of parathyroid function, as seen after thyroidectomy, but other causes include severe vitamin D deficiency, hypomagnesemia, cytotoxic drugs, and large-volume blood transfusions. Early diagnosis and correction are critical, with intravenous calcium being the mainstay of emergency management.