Introduction
The identification of ST-segment elevation pattern on ECG during clinical practise is vital to recognise myocardial ischemia, as timely myocardial reperfusion affects major adverse cardiovascular events (MACE). In clinical practice, the decision to proceed with reperfusion strategy is made before laboratory results are made available. To date, many aetiologies have been associated with pseudo-infarction pattern on ECG other than obstructive coronary disease. Causes such as coronary vasospasm, increased myocardial demand, and electrolyte abnormalities have been demonstrated 1-3. Such knowledge is important to avoid unneeded invasive procedural risks in an unstable patient.
Incidence of post-operative permanent hypoparathyroidism varies from 1.7-68%. Although rare, delayed onset of hypoparathyroidism post thyroidectomy has been reported, and this has been demonstrated in the form of laryngeal spasm, parkinsonism, seizure, and cardiac arrhythmia. We report a case of ST-segment elevation mimicking acute coronary syndrome in the setting of hypokalemia and hypocalcemia with delayed onset post-surgical hypoparathyroidism.