Hypermagnesemia in Emergency Medicine Clinical Presentation

Updated: Jun 23, 2022
  • Author: Nona P Novello, MD; Chief Editor: Erik D Schraga, MD  more...
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Presentation

History

Common causes of hypermagnesemia include renal failure and iatrogenic manipulations. [7] However, other diseases may result in increased magnesium; the degree of elevation determines the symptoms. Acute elevations of magnesium usually are more symptomatic than slow rises.

Magnesium levels of 2-4 mEq/L are associated with the following:

  • Nausea

  • Vomiting

  • Skin flushing

  • Weakness

  • Lightheadedness

High magnesium levels are associated with depressed levels of consciousness, respiratory depression, and cardiac arrest.

Next:

Physical Examination

Physical findings are related to the serum magnesium levels.

Serum magnesium levels of 3.5-5 mEq/L are associated with the following:

  • Disappearance of deep tendon reflexes

  • Muscle weakness

Serum magnesium levels of 5-6 mEq/L are related to the following:

  • Hypotension

  • Vasodilatation

Serum magnesium levels of 8-10 mEq/L are associated with the following:

  • Arrhythmia, including atrial fibrillation

  • Intraventricular conduction delay

  • Flaccid skeletal muscle paralysis

Levels of serum magnesium greater than 10 mEq/L are related to the following:

  • Asystole

  • Heart block

  • Ventilatory failure

  • Stupor or coma

  • Death

Elevated levels of magnesium also are associated with the following:

  • Delayed thrombin formation

  • Platelet clumping

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