A Characteristic Electrocardiographic Manifestation Suggests Hypercalcemia

<b>Background</b>: This study aims to investigate the electrocardiographic (ECG) alterations associated with hypercalcemia, focusing on characteristic T-wave alterations as potential diagnostic indicators. <b>Methods</b>: Utilizing a retrospective observational design, we analyzed ECG data from 64 hypercalcemic patients and a control group of 956 normocalcemic individuals. <b>Results</b>: Our findings reveal that 78.13% of hypercalcemic patients exhibited characteristic T-wave alterations, compared to only 14.64% in the control group (<i>p</i> < 0.001). Additionally, hypercalcemic patients demonstrated significantly shorter mean QT, QTc, and QTm intervals (QT: 340.5 ± 15.4 vs. 380.6 ± 75.5, QTc: 404.2 ± 78.4 vs. 415.7 ± 57.1, QTm: 226.6 ± 23.4 vs. 270.6 ± 27.0; all <i>p</i> < 0.01). Notably, the sensitivity, specificity, and accuracy of T-wave alterations for diagnosing hypercalcemia were 78.12%, 97.28%, and 96.08%, respectively, outperforming QT shortening (sensitivity: 48.43%, specificity: 76.99%). <b>Conclusions</b>: These results indicate that characteristic T-wave alterations are not only prevalent but also provide a reliable diagnostic tool for hypercalcemia, suggesting that integrating ECG analysis into routine clinical practice may enhance early detection and management of this condition.