So welcome to the Internet Booker Critical Care podcast.

I'm here with Adam Thomas and we're going to talk about hypercalcemia.

This one's going to be a short little tidbit that'll be nice for you doing the dishes or going for a run.

So today as usual, we'll cover the signs and symptoms, labs and treatment.

So Josh, let's go right into it, hypercalcemia.

Is it a good, a bad thing, and how do I recognize it in my patients? Yeah, so as far as symptoms

of hypercalcemia, there are a variety of them. They cause psychiatric manifestations, abdominal

pain, constipation, paracetias, muscle weakness. From an ICU-crit critical care standpoint, most of these patients will come to our attention

due to delirium and coma. So that's that old moans, psychogenic tones, that kind of stuff. That's what

you're getting at? Yeah, I can never remember exactly what all those things are. But yeah, abdominal

pain, moans, groans, bones, psychic overtones, I don't know. Yeah, you got it. What do you mean you did that? It's all coming back, baby. Okay, EKG findings. This is super interesting because this is on your mimic for ST elevation, Bradacardia, short QT interval. So usually it doesn't do much on the EKG, but on abrupt changes in serum levels, so very acute or very high levels can cause some trouble. What other things on the EKG should I look for?

You know, I have to say given the fact that calcium is like one of these key ions in the heart,

I'm surprised it doesn't cause more EKG changes.

But yeah, it can reduce the QT interval.

It can cause bundle branch block, AV block and bradycardia.

But most of the time it surprisingly doesn't cause a lot of trouble with the heart. We've talked about it can cause some abdominal pain, constipation, neurologic phenomenon.

Let's move into how symptoms correlate to serum levels. So Josh, I know you're going to slam your

head on the wall. I'm always going to check in the album and corrected calcium, right?

There are basically three levels of goodness here. So the first is the uncorrected total

level of calcium and that is going to be the least accurate because what we really care

about is the amount of free calcium in the blood, which is the ionized calcium. So some calcium

is bounce album. So the uncorrected total calcium is the least useful. Then the next step up

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