Hypomagnesemia: An Overlooked Cause of Delirium and Cardiac Complications in an Elderly Patient.
Level 4 - case-series / case-control
Single patient case report
PubMed 41111863 · doi:10.7759/cureus.92427
What was done
This is a case report of an 81-year-old woman presenting with acute confusion after several days of diarrhea, who underwent diagnostic workup for electrolyte abnormalities and associated cardiac changes.
What was found
Investigations identified severe hypomagnesemia with a serum magnesium level of 0.3 mmol/L, accompanied by ST-segment depression, prolonged QT interval, and elevated troponin levels (managed as type 2 myocardial infarction in the context of sepsis and electrolyte imbalance). Prompt administration of intravenous magnesium replacement led to rapid resolution of delirium and cognitive improvement.
Why it matters
It highlights hypomagnesemia as an underrecognized, reversible cause of delirium and concurrent electrophysiological and ischemic cardiac complications in older adults with gastrointestinal losses.
Limits
This is a single-patient case report (n = 1), precluding any assessment of incidence, causality, or generalizability. The patient also had concurrent sepsis, which is a major confounder for both delirium and type 2 myocardial infarction. Exact numerical values for troponin and QT interval duration were not reported in the abstract.