Hyperparathyroid crisis manifesting as respiratory and heart failure

To describe a case of hyperparathyroid crisis manifesting as respiratory failure and congestive heart failure and to emphasize the implications of hypercalcemia and hypophosphatemia in this setting.

A case report and a review of the pertinent literature are presented.

A 71-year-old man was transferred to our care because of respiratory failure and congestive heart failure. He had no change in cardiorespiratory status until the significance of hypercalcemia and hypophosphatemia was recognized and therapy was directed at correction of these abnormalities. Primary hyperparathyroidism was the cause of these electrolyte abnormalities.

To our knowledge, hyperparathyroid crisis manifesting as respiratory insufficiency and congestive heart failure has not been described previously. Phosphate depletion may account for the neuromuscular features seen in hyperparathyroidism.