Hypocalcemic cardiomyopathy: A case report

Hypocalcemic cardiomyopathy with heart failure: A rare Case report

Hypocalcemia is one of the rarest causes of reversible cardiomyopathy. Patients with refractory heart failure need to be explored for hypocalcemia and need prompt correction.

Abstract

Hypocalcemia is a rare cause of reversible dilated cardiomyopathy. Correction of calcium is crucial to recover left ventricular function and structure. We presented the case of a 55-year-old female who was admitted to the hospital with refractory heart failure due to hypocalcemia induced by primary hypoparathyroidism and complicated by vitamin D deficiency. The patient's cardiac symptoms improved dramatically upon correction of hypocalcemia, and vitamin D. Therefore, the key clinical message of this case report is, that hypocalcemia, although rare, should be considered as one of the differential diagnoses when heart failure is refractory and early diagnosis and treatment is necessary as it is the cause of reversible cardiomyopathy and could reduce morbidity and mortality.

Dilated cardiomyopathy in patients with hypoparathyroidism: A narrative review

Background

Hypoparathyroidism is a rare endocrine disorder characterized by low blood calcium levels, elevated phosphorus levels, and insufficient parathyroid hormone production. It can lead to dilated cardiomyopathy (DCM), a cardiac condition characterized by enlarged ventricles and reduced heart function. This review aims to explore the relationship between hypoparathyroidism and DCM, the impact of calcium on cardiac function, and the potential for DCM reversal with calcium supplementation.

Methods

A comprehensive literature search was conducted using PubMed, Google Scholar, and relevant keywords and Mesh terms. Case reports evaluating dilated cardiomyopathy in patients with Hypoparathyroidism were included in the study. Additionally, references cited in each study were carefully examined to identify relevant reports. The cases included in the review were analyzed, and common cardiac manifestations, diagnostic approaches, and management were identified.

Results

DCM in hypoparathyroidism presents with symptoms of heart failure, reduced ejection fraction, and impaired left ventricular function. Laboratory tests show low serum calcium levels and elevated phosphate levels. Prompt diagnosis and treatment with calcium and vitamin D supplementation can lead to improvements in cardiac function.

Conclusion

Hypoparathyroidism-induced DCM is reversible with timely calcium and vitamin D supplementation. Patient compliance with prescribed medications and supplements is crucial to prevent and manage cardiac complications. Regular follow-up check-ups and monitoring of calcium levels can aid in early detection and improve patient outcomes. Educating patients about the importance of treatment adherence can significantly reduce the risk of developing DCM and other cardiac symptoms associated with hypoparathyroidism. Routine follow-up of DCM among patients with endocrine disorders is recommended.

A Case Report on Hypocalcemic Cardiomyopathy: A Rare Cause of Cardiac Failure

We discuss a case of a 48-year-old man who presented with symptoms of breathlessness, orthopnea, and paroxysmal nocturnal dyspnea. Echocardiogram showed severe left ventricular dysfunction with an ejection fraction of 20% and a coronary angiogram performed later was normal. He was initiated on standard medical management for heart failure. Further blood tests showed that he had severe hypocalcemia secondary to hypoparathyroidism. After the correction of hypoparathyroidism using calcium supplementation and alfacalcidol, his ejection fraction improved to 59%, and 12 weeks later, all anti-failure medications were stopped. A clinical diagnosis of hypocalcemic cardiomyopathy due to hypoparathyroidism was made. The literature review reveals only a few reported cases of heart failure as the initial presentation of dilated cardiomyopathy due to underlying hypocalcemia.