Research Article
Volume 5 Issue 4 - 2021
Wavy Triple Sign of Hypocalcemia or Yasser’s Sign-In Diabetic Ketoacidosis; Reversal Effect and Diverse Management; Retrospective-Observational Study
Yasser Mohammed Hassanain Elsayed*
Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt
*Corresponding Author: Yasser Mohammed Hassanain Elsayed, Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt.
Received: May 22, 2021; Published: May 28, 2021


Aim of the Study: Clarification for the effect of management of diabetic ketoacidosis on both hypocalcemia and electrocardiographic “Wavy triple sign or Yasser’s sign” is the target for the current study.

Background: Hypocalcemia is a well-known serious electrolyte disturbance characterized by calcium deficiency. Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes that usually associated with electrocardiographic and electrolytes changes such as hypocalcemia. An electrocardiographic Wavy triple sign (Yasser’s sign) of hypocalcemia is a new diagnostic sign seen in 97.3% of hypocalcemia.

Method of Study and Patients: The author reported retrospective-observational 27-case report series. The study was conducted in Fraskour Central Hospital in the intensive care unit thorough nearly 15-months, starting from January 14, 2019 and ended on July 12, 2020. All included cases were latent hypocalcemia. Oral calcium and vitamin D preparation on discharge was supplied.

Results: The mean age was: 44.6 years, with female sex predominance (63%). The main complaints in the study were tachypnea (81.48%) vs. and tachypnea with chest pain (18.5%). Diabetic ketoacidosis (70.37%) and combined diabetic ketoacidosis with ischemic heart disease (11.11%) are the most common risk factors. All cases were latent tetany. Complete electrocardiographic recovery without calcium administration in 85.19% vs. nearly normalized response in 11.11% and non-response in 3.7%.

Conclusion: The wavy triple an electrocardiographic sign (Yasser’s sign) and hypocalcemia are commonly seen in diabetic ketoacidosis. Dramatic spontaneous improvement of both wavy triple an electrocardiographic sign (Yasser’s sign) and hypocalcemia simultaneously after the management of diabetic ketoacidosis in most cases.


Keywords: Wavy Triple an Electrocardiographic Sign; Yasser’s Sign in Hypocalcemia; Hypocalcemia; Tetany; Diabetic Ketoacidosis; Reversal Effect


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Citation: Yasser Mohammed Hassanain Elsayed. “Wavy Triple Sign of Hypocalcemia or Yasser’s Sign-In Diabetic Ketoacidosis; Reversal Effect and Diverse Management; Retrospective-Observational Study”. EC Diabetes and Metabolic Research 5.4 (2021): 49-70.

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