Reversible congestive heart failure in severe hypocalcemia

Solzbach, U.; Kitterer, H.-R.; Haas, Hans

doi:10.1007/s00059-010-3374-7

Cited by 15 publications

(11 citation statements)

References 21 publications

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“…A few patients had been erroneously diagnosed with epilepsy or epileptiform seizures 10,11,21,25 . Some patients were also insufficiently treated, or they showed poor cooperation 2,21,42,46 …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Hypocalcaemic cardiomyopathy is a rare form of dilated cardiomyopathy. The authors here present two cases in which symptomatic dilated cardiomyopathy was the result of severe hypocalcaemia. First, we report about a 26-year-old woman with primary hypoparathyroidism and then about a 74-year-old man with secondary hypoparathyroidism following a thyroidectomy. In both cases, the left ventricular systolic function improved after calcium supplementation. In the first case, a lack of compliance led to a repeated decrease of both serum calcium level and left ventricular systolic function. The authors also present a comprehensive summary of all cases of hypocalcaemic dilated cardiomyopathy that have been described in literature to date. The mean age of the affected patients was 48.3 years, of which 62% were female patients. The most common causes of hypocalcaemic cardiomyopathy are primary hypoparathyroidism (50%) and post-thyroidectomy hypoparathyroidism (26%). In the post-thyroidectomy subgroup, the median time for the development of hypocalcaemic cardiomyopathy is 10 years (range: 1.5 months to 36 years). Hypocalcaemic cardiomyopathy leads to heart failure with reduced ejection fraction in 87% of patients. Generally, the most common complications of hypoparathyroidism and/or hypocalcaemia are cerebral calcifications, cognitive deficit, and cataracts. Once calcium supplementation is administered, the disease has a good prognosis and, in most individuals, a significant improvement (21%) or even normalization (74%) of the left ventricular systolic function occurs.

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Section: Discussionmentioning

confidence: 99%

“…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.).…”

Section: Case Reportmentioning

confidence: 99%

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

et al. 2020

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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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“…4 Hypocalcemia is a rare but treatable and reversible cause of dilated cardiomyopathy and therefore should be investigated in all unexplained cases of severe left ventricular dysfunction. 5,6 Primary hypoparathyroidism (HPTP) is characterized by an abnormally low level of secretion of parathyroid hormone (PTH), a hormone that plays a key role in calcium homeostasis.…”

Section: Discussionmentioning

confidence: 99%