Introduction
The identification of ST-segment elevation pattern on ECG during
clinical practise is vital to recognise myocardial ischemia, as timely
myocardial reperfusion affects major adverse cardiovascular events
(MACE). In clinical practice, the decision to proceed with reperfusion
strategy is made before laboratory results are made available. To date,
many aetiologies have been associated with pseudo-infarction pattern on
ECG other than obstructive coronary disease. Causes such as coronary
vasospasm, increased myocardial demand, and electrolyte abnormalities
have been demonstrated 1-3. Such knowledge is
important to avoid unneeded invasive procedural risks in an unstable
patient.
Incidence of post-operative permanent hypoparathyroidism varies from
1.7-68%. Although rare, delayed onset of hypoparathyroidism post
thyroidectomy has been reported, and this has been demonstrated in the
form of laryngeal spasm, parkinsonism, seizure, and cardiac arrhythmia.
We report a case of ST-segment elevation mimicking acute coronary
syndrome in the setting of hypokalemia and hypocalcemia with delayed
onset post-surgical hypoparathyroidism.