HYPOmagnesemia HYPERmagnesemia A 35-year-old known male alcoholic presents to the ER with EKG findings consistent with torsaded des pointes. A 26-year-old female who is currently hospitalized for eclampsia becomes lethargic with decreased reflexes. EKG shows a prolonged PR and QT interval. Introduction Introduction Causes include diarrhea malabsorption vomiting diuresis alcoholism chemotherapy Causes include over replacement in renal failure patients over replacement with seizure prophylaxis in preeclampsia patients Presentation Presentation Symptoms torsades des pointes v-fib a-fib hyperreflexia tetany Symptoms lethargy weakness decreased DTR paralysis decreased BP and HR Evaluation Evaluation EKG findings T wave widening QRS widening prolonged PR interval prolonged QT interval EKG findings (almost same as hypomag.) prolonged PR interval prolonged QT interval Treatment Treatment MgSO4 Calcium gluconate normal saline infusion loop diuretic dialysis