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HypomagnesemiaHypomagnesemia – General InformationHypomagnesemia is considered an electrolyte malfunction caused by the abnormal low level of magnesium in the patient’s blood. When an individual suffers from this disease he presents in the blood a level of magnesium smaller than 0.7mmol/l. It is important to take into consideration the fact that the disease is not the same thing with magnesium deficiency. There are many conditions that can cause the appearance of Hypomagnesemia and can include malabsorption, alcoholism, chronic stress, improper administration of magnesium, chronic diarrhea and diuretic use. The signs and symptoms of the condition usually appear in the central nervous system, neuromuscular, gastrointestinal and cardiac system. In most cases, malnutrition is the cause of the disease, especially when patients prefer a magnesium low diet. Doctors can recommend diets full in green vegetables, fruits, fish, fresh meat, and cereals. There are also cases in which alcohol consumers develop the disease. Diabetic patients usually receive medications without magnesium as part of the treatment trial for their disease, fact that causes the condition. Renal losses from primary and secondary causes, such as osmotic load and drugs, can also cause Hypomagnesemia. There are cases in which certain medication caused the appearance of the disease, and can include diuretics, cisplatin, which causes kidney damage, pentamidine, which cause renal magnesium wasting, and fluoride poisoning. Sometimes, the disease can be caused by endocrine disorders such as primary aldosteronism (increases the renal flow), hypoparathyroidism and hyperthyroidism. It is important to treat the disease in an early stage to prevent future complications and increase the cure rate.Hypomagnesemia – SymptomsTo diagnose Hypomagnesemia, the doctor can take into consideration the historical complaints, the presence of specific signs such as weakness, muscle cramping, or rapid heartbeats, and altered mental status, which appears in severe cases, or vertigo, ataxia, depression, and seizure activity, which appears in moderate cases. The first signs and symptoms of the disease appear as neuromuscular irritability, central nervous system hyperexcitability and cardiac arrhythmias. In most cases, the gravity of the symptoms does not depend on the level of magnesium. Sometimes, the disease can cause no signs and symptoms at all. The symptoms usually differ depending on the part of the body that is affected by Hypomagnesemia. They can include neuromuscular irritability, which can present hyperactive deep tendon reflexes, muscle cramps, muscle fibrillation, Trousseau or Chvostek syndrome signs, dysarthria and dysphagia from esophageal dysmotility; central nervous system hyperexcitability, which can present irritability and combativeness, disorientation, psychosis, ataxia, vertigo, nystagmus, seizures, cardiac arrhythmias, that can be caused by the disease in combination with hypokalemia due to decreased function of ATPase, which can present paroxysmal atrial and ventricular dysrhythmias and repolarization alternans; and neonates which can present apnea, weakness, psychosis, ataxia, vertigo, nystagmus, seizures and jitteriness. There are cases in which patients who suffer from Hypomagnesemia can present fast heart rate which can cause high blood pressure. It is very important to treat the condition in an early stage in order to prevent more severe complications. To prevent the appearance of this kind of disease it is recommended to apply a diet rich in magnesium.Hypomagnesemia – TreatmentThe diagnosis of this medical disorder can be made by measuring the plasma magnesium concentration, and if the patient suffers from Hypomagnesemia, this concentration is less than 0.7mmol/l. Due to the fact that magnesium is an intracellular substance; a body deficit can have a normal plasma concentration. Usually, in less than half of the cases, patients who suffer from this disease can develop hypocalcemia; more than half of the cases can develop hypokalemia. The treatment for Hypomagnesemia depends on the stage, the severity and the signs and symptoms the disease causes. In most cases, for patients who experience mild symptoms, the first option is oral replacement, while for patients who present severe signs the first option is intravenous replacement. The IV operation with magnesium sulphate can be administered if the patient also suffers from arrhythmia, obstetric, electrolyte disturbances and pulmonary deficiencies. Generally, the magnesium is responsible with the function of NA/K ATPase pumps that are located inside the cells of the patient’s heart. Decreased levels of magnesium can cause depolarization which can lead to the appearance of tachyarrythmia. Magnesium also acts as an inhibitor in releasing potassium; a decreased level of magnesium can increase the loss of potassium. Low levels of potassium can also cause the cells depolarization. There are two major conditions that inhibit the Na/K pumps decreasing the intracellular levels of potassium. Magnesium, if is administered intravenously, can be effective for the refractory form of arrhythmia, also known as torsade the pointes. There are many other heart medical conditions that can be treated with this procedure and can include ventricular tachycardia, supraventricular tachycardia and atrial fibrillation. This operation acts by decreasing excitability causing a depolarization and slowing down of electric signals in the atrio-ventricular node. Due to the decreased calcium influx and calcium releases from intracellular deposits, magnesium is considered a negative inotrope. The most common type of medicine that contains this substance is verapamil. A lack of magnesium can cause myocardial infraction, which is a life threatening medical condition, and the administration of the substance can decrease death rate. For the obstetric condition the first operation is pre-eclapsia. This kind of operation acts on the patient’s thrombocytes and the endothelial functions, which increase the secretion of prostaglandin, and decrease the secretion of thromboxane and angiotensin II, and has the same effect like the calcium channel blockers. The vasodilatatory effect of the magnesium can cause cerebral vasospasm which can lead to the appearance of convulsions. The major electrolyte disturbances of Hypomagnesemia are hyocalcemia and hypokalemia. Hypocalcemia appears due to the decreased function of calcium pumps. Hypokalemia appears in patients who do not respond to potassium administration, due to the decreased function of the Na/K pump. Magnesium can also have a bronchodilatatory effect, and a lack of it can cause acute asthma. Health care providers apply an adrenergic stimulation using sympatheticomimetics to treat asthma, which can decrease the levels of magnesium. To treat Hypomagnesemia doctors can also apply sedation and anxiolytics, which can also decrease bronchoconstriction. |
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