ABSTRACT
Hypertrophic cardiomyopathy often occurs with hyperthyroidism. Assessment of cardiac function by thoracic radiographs, electrocardiogram and echocardiogram is performed before surgery. Care is taken to prevent volume overload of the heart. ii. Tetany from hypocalcemia occurs from iatrogenic injury to the parathyroid glands during bilateral thyroidectomy. iii. If hypocalcemia is severe (serum calcium <1.5 mmol/l (<6 mg/dl)), supplementation with slow i/v boluses of calcium chloride or calcium gluconate (calcium gluconate 1%: 0.5-1.5ml/kg) is given to effect during tetany; the ECG is monitored concurrently for arrythmias. Calcium chloride (1 g/250 ml of maintenance fluids) is useful to maintain normal serum calcium. Calcium supplements must not be added to lactate, acetate or bicarbonate solutions since precipitates may occur. Calcium supplementation is temporary until parathyroid gland function returns, or vitamin D therapy is initiated for long-term management of hypocalcemia.
