Hypocalcemic Cardiomyopathy in a Patient with Idiopathic Hypoparathyroidism.

Kudoh, Chika; Tanaka, Shigemichi; Marusaki, Shigeru; Takahashi, Naoko; Miyazaki, Yoshihiro; Yoshioka, Nobuhiro; Hayashi, Manabu; Shimamoto, Kazuaki; Kikuchi, Kenjiro; Ito, Osamu

doi:10.2169/internalmedicine.31.561

Cited by 31 publications

(28 citation statements)

References 19 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%

“…Experimental studies demonstrated reduced cardiac contractility in hypocalcemic states, as evidenced by decreased LV performance and cardiac index (44,45), and suggested an increase in myocardial contractility and cardiac output with calcium correction (46,47). However, clinical heart failure in patients with hypocalcemia is rare, probably because it is a late complication, most commonly following the onset of neuromuscular irritability (15). Also, in chronic hypocalcemic states poorly defined mechanisms may initially attempt to maintain adequate cardiomyocyte contraction, mechanisms that no longer operate effectively in severe hypocalcemia (20).…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…In vielen Fällen entstehen im weiteren Krankheitsverlauf die Folgeschäden des Hypoparathyreoidismus, wie z. B. Herzinsuffizienz [18], eine Verkalkung der Basalganglien [8] oder Osteoporose [10].…”

Section: Beschwerdebildunclassified

Das weitgehend unbekannte Krankheitsbild des postoperativen permanenten Hypoparathyreoidismus - Konzeption und Validierung eines innovativen Fragebogenmessinstrumentes

Bohrer

Fleischmann²,

Tersteegen³

et al. 2005

Zentralbl Chir

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Aim of our study has been the systematic evaluation concerning the still farmost unknown disease of postoperative, permanent hypoparathyroidism. For this we designed a specific questionnaire as measuring instrument--it was evaluated by experts and validated by 3 control groups--to examine then a patient group (n = 20) with symptomatic postoperative, permanent hypoparathyroidism. The application of the questionnaire was very feasible, the reliability of measuring scales according to Cronbach's alpha > or = 0.70. The validity of content and construct validity fully existed (Pearson's correlation coefficient r > or = - 0.27; p < 0,05). The farmost frequent clinical complaints were peripheral cold sensations (65 %), pains in joints (55 %), sensation of heaviness and weakness in extremities (55 %) and paresthesias (45 %). Most frequent clinical symptoms were brittle nails (40 %) and diarrhoea (35 %). Sum and distress level scores for classification of illness severity were determined. In conclusion our questionnaire is a valid instrument and from a clinical point of view easy to apply, reasonable and very feasible in practical use. It represents a novel, optimum instrument to determine disease condition and illness severity of hypoparathyroid patients and makes it possible to gain further information of this up to now less systematically analysed disease.

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“…The original prolonged QT interval improved to normal values after correction of hypocalcemia thyroidism has been described in some case reports [12,13,14,15,16,17,18,19], but in major textbooks this subject matter is often only briefly mentioned [20,21,22]. This is probably a reflection of the rare finding of congestive heart failure induced by hypocalcemia in clinical practice.…”

Section: Hypocalcemic Cardiomyopathy Is Rare But Possibly Often Overlmentioning

confidence: 99%

Reversible congestive heart failure in severe hypocalcemia

Solzbach¹,

Kitterer²,

Haas³

2010

Herz

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We present a case of severe congestive left heart failure due to profound and long-term hypocalcemia caused by surgically induced hypoparathyroidism. Hypocalcemia as a potential contributor to heart failure should be included in the differential diagnosis of all patients with congestive heart failure who do not respond adequately to the usual treatment. By rapid correction of the serum calcium level unnecessary diagnostic and therapeutic measures might be avoided. In addition, being aware of and treating hypocalcemia is crucial since this kind of heart failure is completely reversible with calcium and vitamin D treatment.The pivotal role of calcium in molecular and cellular biology is well known, but its clinical importance in day-to-day practice is often underestimated. Although some cases of heart failure resulting from hypocalcemia secondary to hypoparathyroidism have been published in the last 20 years, this subject is still poorly documented in almost all current textbooks.

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Hypocalcemic Cardiomyopathy in a Patient with Idiopathic Hypoparathyroidism.

Cited by 31 publications

References 19 publications

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy

Das weitgehend unbekannte Krankheitsbild des postoperativen permanenten Hypoparathyreoidismus - Konzeption und Validierung eines innovativen Fragebogenmessinstrumentes

Reversible congestive heart failure in severe hypocalcemia

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