Case 90. A 76 year old woman has been admitted with heart failure, involving oedema and pulmonary oedema. For the past 4 days she has been on ACE inhibitors, furosemide, thiazide diuretics and b blockers. She has recently developed fasciculations, worsening heart. Investigations: Hypokalaemia, Hypocalcaemia, tremor, fasciculations, low PTH. What may be the underlying cause for her recent deterioration?
Magnesium deficiency. - This is the commonest cause of hypocalcaemia in hospitals.