Hypocalcemia Precipitating Congestive Heart Failure

Connor, Thomas B.; Rosen, Barry L.; Blaustein, Mordecai P.; Applefeld, Mark M.; Doyle, L. Austin

doi:10.1056/nejm198209303071407

Cited by 98 publications

(43 citation statements)

References 13 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

Ballane

Sfeir

Dakik³

et al. 2012

European Journal of Endocrinology

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Hypocalcemia secondary to hypoparathyroidism is a rare cause of congestive heart failure. However, its early recognition and treatment lead to significant improvement in cardiac function. We report a middle-aged woman presenting with symptoms of heart failure with a serum calcium level of 3.7 mg/dl and a serum inorganic phosphate level of 17.6 mg/dl 22 years after subtotal thyroidectomy. Besides calcium and calcitriol supplementation, she was the first patient with severe hypocalcemic cardiomyopathy to be given off-label recombinant human parathyroid hormone (PTH) because of an elevated serum calcium–phosphate product. We discuss the management and outcome of the patient and then present a brief review of similar previously reported cases. We also describe the pivotal role of calcium ion and the potential role of PTH in maintaining myocardial contractility, effective natriuresis, and possible pathogenic mechanisms contributing to heart failure secondary to hypocalcemia and hypoparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

Ballane

Sfeir

Dakik³

et al. 2012

European Journal of Endocrinology

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“…It can lead to serious conditions [13,14]; it has been suggested that hypocalcemia is associated with the severity of disease and fairly predicts mortality in critically ill patients [15][16][17]19]. Hypocalcemia in critical illness is presumably multifactorial.…”

Section: Discussionmentioning

confidence: 99%

“…Simple treatment with vitamin D and calcium has been shown to correct serum calcium and to reduce the fracture risk [9][10][11][12]. In addition, resulting hypocalcemia may lead to serious acute sequelae including neuromuscular irritability, tetany, laryngospasm [13], seizure, arrhythmia, heart failure [14], and death. Despite its high prevalence and important public health implications, vitamin D deficiency is frequently overlooked.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency as an Ignored Cause of Hypocalcemia in Acute Illness: Report of 2 Cases and Review of Literature

Noto¹,

Heller²

2009

TOEJ

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Abstract:We describe the clinical and laboratory findings in 2 cases of hypocalcemia secondary to vitamin D deficiency in intensive care unit and the response of calcium to treatment. We also discuss the mechanism and review pertinent literature. The first patient was admitted due to stroke. Laboratory data included serum calcium 7.6 mg/dl, intact parathyroid hormone (PTH) 891.6 pg/ml, 25-hydroxyvitamin D (25-OH-D) 7 ng/ml (17.5 nmol/l), 1,25-dihydroxyvitamin D (1,25-OH-D) 43 pg/ml (103.2 nmol/l), and corrected QT (QTc) interval 494 msec. After two weeks of treatment with oral calcium and ergocalciferol, serum calcium and intact PTH levels and QTc interval normalized. The second patient was transferred for the management of disseminated cytomegalovirus infection. Laboratory work-up revealed serum calcium 7.7 mg/dl, creatinine 4.3 mg/dl, intact PTH 207.5 pg/ml, 25-OH-D <5 ng/ml (<12.5 nmol/l), 1,25-OH-D <10 pg/ml (<24 nmol/l), and QTc interval 505 msec. After treatment for vitamin D deficiency and infection, we observed normalization of creatinine, corrected calcium, intact PTH and QTc interval. The clinical courses were uneventful in both cases. In conclusion, we would like to emphasize that vitamin D status should be evaluated in patients with hypocalcemia in acute settings because vitamin D deficiency is common and readily treatable, and there may be clear life-threatening consequences if it is not treated.

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“…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].…”

Section: Discussionmentioning

confidence: 99%

Cardiac failure secondary to hypocalcemia

Namazi

Khaheshi

Charkhkar

et al. 2016

ijcp

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Hypocalcemic cardiomyopathy due to hypoparathyroidism is a very atypical and rare circumstance, which is usually intractable to conventional therapy for cardiac failure, but responds satisfactorily to restoration of normocalcemia. We describe a young woman who developed clinical signs of hypocalcemia due to hypoparathyroidism, reduced left ventricular ejection fraction and polymorphic ventricular tachycardia as consequences of hypocalcemia. This case underscores the importance of biochemical abnormalities like hypocalcemia as a rare cause of secondary cardiomyopathy and emphasizes on the need for effective and immediate treatment of hypocalcemia and its related causes.

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Hypocalcemia Precipitating Congestive Heart Failure

Cited by 98 publications

References 13 publications

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

Vitamin D Deficiency as an Ignored Cause of Hypocalcemia in Acute Illness: Report of 2 Cases and Review of Literature

Cardiac failure secondary to hypocalcemia

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