Sinus node dysfunction and tach-brady syndrome.Less common causes are immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison’s disease, renal failure, tamoxifen, lithium, thiazide diuretics, D vitamin and calcium overdose. Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcemia. Calcium Hypercalcemia Causes of hypercalcaemia Increased (hypernatremia) and decreased (hyponatremia) sodium levels do not have any effect on the ECG, nor cardiac rhythm, or impulse conduction. This is possible because there is a correlation between the severity of electrolyte imbalance and the visible ECG changes. The ECG may be used to estimate the severity of electrolyte imbalances and to judge whether there is a risk of serious arrhythmias. Note that some patients may exhibit combined electrolyte imbalance. The most common and clinically most relevant electrolyte imbalances concern potassium, calcium and magnesium. Some electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life-threatening. The normal cardiac action potential may be altered by electrolyte imbalance, owing to changes in intra- and extracellular electrolyte concentrations. ECG changes due to electrolyte imbalance (electrolyte disorder)
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