In a hypercalcemic patient undergoing anesthesia, what is the primary intraoperative risk?

In a hypercalcemic patient undergoing anesthesia, what is the primary intraoperative risk?

• A. Coagulopathy
• B. Cardiac dysrhythmias
• C. Hypotension
• D. Laryngospasm

Answer: (B)

Hypercalcemia directly alters cardiac electrical activity, making the heart prone to dysrhythmias during anesthesia. Calcium increases myocardial excitability and shortens the plateau phase of the cardiac action potential, which shortens the QT interval and raises the risk of ectopic beats and more serious arrhythmias. Under anesthesia, with stress, catecholamine release, and various drugs affecting conduction, this predisposition can manifest as intraoperative rhythm disturbances. While hypotension, coagulopathy, or laryngospasm can occur for other reasons, the specific and most concerning intraoperative risk in a hypercalcemic patient is cardiac dysrhythmias.

Hypercalcemia directly alters cardiac electrical activity, making the heart prone to dysrhythmias during anesthesia. Calcium increases myocardial excitability and shortens the plateau phase of the cardiac action potential, which shortens the QT interval and raises the risk of ectopic beats and more serious arrhythmias. Under anesthesia, with stress, catecholamine release, and various drugs affecting conduction, this predisposition can manifest as intraoperative rhythm disturbances. While hypotension, coagulopathy, or laryngospasm can occur for other reasons, the specific and most concerning intraoperative risk in a hypercalcemic patient is cardiac dysrhythmias.