Hypocalcemic cardiomyopathy: a rare presenting manifestation of hypoparathyroidism

Abstract

Hypoparathyroidism patients present with features of hypocalcemia like carpopedal spasm, numbness and paresthesias but hypocalcemic cardiomyopathy leading to congestive heart failure (CHF) is a rare presentation. We present here a case of 55-year-old Asian man who was a known case of dilated cardiomyopathy for 6 months, presented with the chief complaints of shortness of breath on exertion and decreased urine output. On general physical examination, features suggestive of CHF were seen. Chvostek and Trousseau’s sign was positive. The patient had a history of cataract surgery of both eyes 15 years ago. Further investigations revealed hypocalcemia. Echo showed severe global hypokinesia of left ventricle with left ventricle ejection fraction 15%. This CHF was refractory to conventional treatment, though, with calcium supplementation, the patient improved symptomatically. On follow-up after 3 months, an improvement was seen in the echocardiographic parameters with ejection fraction improving to 25%.

Hypocalcaemic cardiomyopathy: a description of two cases and a literature review

“…Our two cases were also included in the overall evaluation. A total of 57 articles describing 61 cases were found 2–58 . All publications were independently evaluated by two researchers (M. V. and L. R.).…”

Hypocalcemic cardiomyopathy after parathyroidectomy in a patient with uremia: A case report and literature review

“…The current literature indicates that hypocalcemia, hypovitaminosis, and hypoparathyroidism can lead to reversible cardiomyopathy. 3,[6][7][8][9][10][11][12][13] In the present case, there was considerable hypocalcemia and hypoparathyroidism. However, because vitamin D concentrations were not monitored, we are unable to determine if hypovitaminosis was involved in hypocalcemic cardiomyopathy.…”

Hypocalcemia as a cause of reversible heart failure: A case report and review of the literature

“…Primary hypoparathyroidism (PHPT) is defined by an abnormally low amount of PTH release [ 7 ]. The primary function of PTH is to keep the calcium concentration in extracellular fluid (ECF) within a narrow normal range [ 8 ]. Hypocalcemia can therefore result from PTH deficiency [ 7 ].…”

“…Hypocalcemia-induced heart failure is resistant to diuretics and digitalis [ 8 ]. Surprisingly, once serum calcium concentration is normalized, cardiac function and pulmonary artery pressure are completely restored to normal [ 20 ].…”