QT PROLONGATION SECONDERY TO HYPOCALCEMIA AFTER CORRECTION FOR ELEVATED SERUM ALBUMIN. A. Hamad 1 , M. Zihlif 1 , M. Salameh 1 , A. Alghadban 2 , D. Feinfeld 1 ; 1 Nassau University Medical Center, Eastmeadow, New York; 2 SUNY at Stony Brook, Port Jefferson NY LEARNING OBJECTIVE: 1-recognize that correction of calcium level for albumin should be done also if albumin is high. CASE INFORMATION: 42 years old white male with no significant past medical history except alcoholism came to the emergency room with vomiting of small amount of blood associated with mild epigastric pain. He was not taking any medications at home. He was afebrile, blood pressure was 123/83, heart rate was 126 bpm. Physical exam was unremarkable except for mild dehydration and tachycardia with no added sounds or murmur. Laboratory tests were significant for normal calcium level (9 mg/dl), magnesium of 2 meq/dl, serum albumin of 5.3 mg/dl, potassium of 3.3 meq/dl. Arterial blood gas showed normal pH of 7.44. Electrocardiogram showed regular sinus rhythm with prolonged QT interval (QTc = 44 msec). Because of this prolongation, the patient was given calcium gluconate intravenously as corrected calcium with elevated albumin was low (7.9 mg/dl). Ionized calcium was low (1.04 meq/dl. Repeat EKG showed return of QT interval to normal limit. The patient was treated with vitamins and anxiolytics for his mild alcohol withdrawal and was discharged home after 2 days. DISCUSSION: QT prolongation can occur as a congenital or an acquired disorders. The acquired form is secondary to pharmacologic agents (mainly antiarrhythmatics, tricyclic antidepressants, antihistamines and erythromycine), and electrolytes disturbances (hypokalemia, hypomagnesemia and hypocalcemia). We are presenting this case to stress on fact of correcting calcium level to the serum albumin, this correction can be by adding 0.8 mg to each 1 mg of albumin below the normal level (4mg/dl) or by subtracting 0.8 mg to each 1 mg of albumin above the normal limit.