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[Reversible hypokinetic cardiomyopathy revealing severe hypocalcemia]
J C Charniot1, A Alexeeva, S Laurent
1Service de cardiologie, hôpital Avicenne, 125, route de Stalingrad, 93009 Bobigny.
Insights
Severe hypocalcemia due to primary hypoparathyroidism can cause dilated cardiomyopathy and cardiac failure. Treatment of hypocalcemia can reverse cardiac dysfunction, highlighting this biochemical abnormality as a treatable cause of heart disease.
Area of Science:
- Cardiology
- Endocrinology
- Biochemistry
Background:
- Dilated cardiomyopathy (DCM) is often idiopathic or secondary to toxins or infections.
- Biochemical abnormalities are less common causes of DCM.
- Primary hypoparathyroidism is a rare endocrine disorder characterized by insufficient parathyroid hormone production.
Observation:
- A 58-year-old woman presented with new-onset cardiac failure.
- Electrocardiogram (ECG) revealed sinus tachycardia and a prolonged QT interval (560 ms).
- Echocardiography showed dilated hypokinetic cardiomyopathy with a reduced left ventricular ejection fraction (20%).
Findings:
- Aetiological investigation identified severe hypocalcemia (0.66 mmol/L).
- The hypocalcemia was attributed to primary hypoparathyroidism.
- This biochemical abnormality was the underlying cause of the cardiac dysfunction.
Implications:
- Primary hypoparathyroidism should be considered in the differential diagnosis of unexplained dilated cardiomyopathy.
- Correction of hypocalcemia can lead to significant improvement or resolution of cardiac disease.
- Early diagnosis and treatment of hypoparathyroidism can prevent irreversible cardiac damage.
Abstract:
Dilated cardiomyopathy may be primary or secondary. Although some causes are well known, such as toxic substances (alcohol, chemotherapy...) or viral infections, biochemical abnormalities are much less common. The authors report the case of a 58 year old woman with no previous history admitted to hospital for an inaugural episode of cardiac failure. The ECG showed sinus tachycardia with a long QT interval (560 mm) and a dilated hypokinetic cardiomyopathy with a left ventricular ejection fraction of 20%. The aetiological investigation showed severe hypocalcaemia (0.66 mmol/L) related to primary hypoparathyroidism. This is an important cause to remember because its treatment leads to correction of the cardiac disease, usually within weeks.