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Hypocalcemic cardiomyopathy.

Patrício Aguiar¹, Diogo Cruz, Rita Ferro Rodrigues

¹Serviço de Medicina 1, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal. patricio_aguiar@yahoo.com.br

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology

|April 16, 2013

Summary

Hypocalcemia, a rare cause of heart failure, can lead to hypocalcemic cardiomyopathy. Prompt diagnosis and calcium replacement therapy can fully reverse heart failure symptoms in affected patients.

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Area of Science:

Cardiology
Endocrinology

Background:

The association between hypocalcemia and heart failure is uncommon, with limited documented cases of hypocalcemic cardiomyopathy.
This report details a rare instance of hypocalcemic cardiomyopathy.

Observation:

A 61-year-old woman presented with severe dyspnea, orthopnea, and edema, indicative of heart failure.
Physical examination revealed diffuse muscle spasms. Laboratory tests showed severe hypocalcemia (ionized calcium 0.54 mmol/l), elevated CK, and low parathyroid hormone.
Electrocardiogram demonstrated a prolonged QT interval and left ventricular overload. Echocardiogram revealed regional wall motion abnormalities. Cranial CT scan showed basal ganglia and white matter calcification.

Findings:

The patient was diagnosed with hypocalcemic cardiomyopathy.
Treatment with diuretics and calcium replacement therapy led to complete clinical recovery.
Heart failure symptoms resolved entirely upon normalization of serum calcium levels, negating the need for heart failure-specific medications.

Implications:

This case highlights the importance of considering and investigating hypocalcemia in patients presenting with heart failure, especially when other causes are ruled out.
Early detection and management of hypocalcemia are crucial for reversing cardiac dysfunction and improving patient outcomes.
Hypocalcemic cardiomyopathy is a potentially reversible cause of heart failure, emphasizing the need for comprehensive metabolic evaluation in undiagnosed cardiac conditions.