ABSTRACT
BACKGROUND: Laryngospasm is a rare cause of stridor in adults, and laryngospasm due to hypocalcemia is an unusual finding. CASE REPORT: We present a case of an adult woman with acute dyspnea. A week prior to presentation, she experienced short episodes of a pinching feeling in her throat and difficulty breathing. On primary assessment, stridor and a positive Trousseau sign were noted. Laboratory examination showed hypocalcemia. We concluded that the dyspnea was caused by laryngospasm due to hypocalcemia. Hypocalcemia was treated promptly, and stridor and dyspnea resolved rapidly. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Laryngospasm is a rare, but serious and potentially lethal, complication of hypocalcemia in adults. In every adult presenting with acute dyspnea and stridor, the possibility of hypocalcemia should be considered. Hypocalcemia should be treated promptly.
Subject(s)
Dyspnea/etiology , Hypocalcemia/complications , Laryngismus/etiology , Acute Disease , Aged , Female , Humans , Hypocalcemia/drug therapy , Respiratory SoundsABSTRACT
A 67-year-old man accidentally ingested 75â g of sodium nitrate. He had instant gastrointestinal symptoms. On physical examination, he was respiratorily and haemodynamically stable and there were no signs of central or peripheral cyanosis. Repeated methaemoglobin levels were normal and he made an uneventful recovery. Sodium nitrate intoxication is rare. Serious effects can occur, mainly through formation of nitrite and nitric oxide, which can cause methaemoglobinaemia and vasodilation. Even if the presenting symptoms are mild, it is important to remain cautious since more serious symptoms can occur later. Monitoring of respiratory and haemodynamic status and repeated blood gas analysis in order to detect methaemoglobinaemia are recommended.
