Cardiac failure secondary to hypocalcaemia of nutritional osteomalacia

Area of Science:

• Internal Medicine
• Cardiology
• Endocrinology

Background:

• Congestive cardiac failure (CCF) can be challenging to manage, especially when resistant to standard treatments.
• Osteomalacia, a bone disease, can present with varied symptoms, including cardiac complications.
• Hypocalcemia is a known, but less common, cause of cardiac failure.

Observation:

• A 41-year-old woman initially presented with mild CCF, which later deteriorated significantly.
• Her condition became resistant to conventional diuretic therapy.
• Biochemical analysis revealed hyperphosphataemic osteomalacia.

Findings:

• The patient's severe cardiac failure showed prompt improvement upon correction of hypocalcemia.
• This suggests a direct link between hypocalcemia secondary to osteomalacia and cardiac dysfunction.
• The specific presentation of cardiac failure in privational osteomalacia was noted.

Implications:

• This case underscores the importance of considering metabolic bone diseases like osteomalacia in patients with unexplained or refractory cardiac failure.
• Prompt identification and management of associated hypocalcemia can lead to significant clinical improvement.
• Further research may explore the prevalence and mechanisms of cardiac involvement in different types of osteomalacia.