Hypercalcemia is usually discovered incidentally by laboratory diagnosis before the development of symptoms.
The following symptoms and complaints may indicate hypercalcemia:
Eyes
- Cornea (cornea of the eye): band-like degeneration.
Heart
- Shortened QT time in ECG
- Cardiac arrhythmias (arrhythmia, bradycardia (heartbeat too slow: < 60 beats per minute)).
- Hypertension (high blood pressure)
- Valve calcifications
Gastrointestinal tract (gastrointestinal tract)
Kidney
- Nephrolithiasis (kidney stones)
- Nephrocalcinosis (deposition of calcium salts in the renal vessels and connective tissues of the kidney).
- Renal insufficiency (kidney weakness)
- Polydipsia (excessive thirst)
- Polyuria (increased urine output: > 1.5-3 l/day).
Musculoskeletal system
- Arthralgia (joint pain)
- Bone pain
- Muscle weakness
- Myalgia (muscle pain)
Nervous system
- Fatigue
- Lethargy
- Confusion
- Depression
- Reflex attenuation
- Somnolence (drowsiness with abnormal sleepiness while maintaining responsiveness and arousal).
- Coma
- Brain Organic Psychosyndrome (HOPS)
Further
- Decrease in performance
- Cave: digitalis (→ calcium content increases intracellularly).
Hypercalcemic crisis (total serum calcium of > 3.5 mmol/l) may be associated with the following symptoms:
- Polyuria (increased urine output).
- Desiccosis (dehydration)
- Hyperpyrexia (extreme fever: higher than 41 °C).
- Cardiac arrhythmias
- Weakness
- Lethargy
- Somnolence to coma.
Warning signs (red flags)
- Weight loss → think of: Malignancy (tumor disease)/tumor hypercalcemia.
