A Rare Cause of Reversible Dilated Cardiomyopathy: Hypocalcemia

Abstract

Hypocalcemia is a rare cause of reversible heart failure. We reported a 40-year-old woman who had severe heart failure resistant to the usual antifailure therapy. She had severe hypocalcemia due to hypoparathyroidism after strumectomy. Echocardiography showed a large left ventricle with very low ejection fraction of 25% and moderate mitral regurgitation. After supplementation of calcium and vitamin D, her clinical situation and hemodynamics improved rapidly. At 15 months, myocardial impairment resolved fully. In conclusion, hypocalcemia should be considered in the differential diagnosis of resistant severe heart failure.

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

“…Hypocalcemic cardiomyopathy has been described in more than 25 reports in the literature and in all age groups (3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33). We conducted a search in Pubmed using keywords 'hypocalcemia (all fields) AND heart failure (all fields)' yielding 221 entries.…”

Cardiac failure secondary to hypocalcemia

“…Hypocalcemia diminishes myocardial contractility, but the prevalence of congestive heart failure due to hypocalcemia is uncommon [2,3]. Hypocalcemic cardiomyopathy due to hypoparathyroidism is a very atypical circumstance which is usually intractable to conventional therapy for cardiac failure, but responds satisfactorily to restoration of normocalcemia [4,5].…”

“…Even if some causes are familiar, such as toxic agents (alcohol or drugs of chemotherapy) or viral and bacterial infections, biochemical abnormalities are much less common [1]. Hypocalcemia diminishes myocardial contractility and results in left ventricular systolic dysfunction [2]. In this paper, we report a case of heart failure with hypocalcemia and primary hypoparathyroidism which was treated with vitamin D and calcium supplement.…”

Miocardiopatía por hipocalcemia

“…Así el hipoparatiroidismo con o sin hipocalcemia puede llevar a insuficiencia cardíaca refractaria a terapia convencional 4 . Se ha descrito, ya por varios autores 5-9 , la presencia de insuficiencia Cardíaca Congestiva por disfunción sistólica y diastólica en relación a hipocalcemia crónica, condición que ha demostrado reversibilidad al administrar calcio y vitD en forma mantenida [10][11][12][13][14] . En nuestro paciente el diagnóstico se evidenció luego de varias hospitalizaciones por IC Descompensada, en los que siempre ingresaba con hipocalcemia.…”