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[Dilated cardiomyopathy secondary to idiopathic hypoparathyroidism in adults. Description of a case]
V Palazzuoli1, G Martini, S Giovani
1Istituto di Clinica medica generale e Terapia medica, Università, Siena.
Insights
Undiagnosed hypocalcemia can cause cardiomyopathy. Correcting calcium levels with calcitriol effectively treated the condition, improving heart function and reducing ventricular size.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Cardiomyopathy is a significant cause of heart failure.
- Hypocalcemia, a condition of low serum calcium, can present with diverse symptoms.
- The cardiac manifestations of hypocalcemia are often overlooked in differential diagnoses.
Observation:
- A 56-year-old male presented with cardiomyopathy characterized by heart dilation and hypokinesia.
- Cardiac failure was refractory to standard treatments like digitalis and diuretics.
- Echocardiography revealed impaired ventricular wall motion and an enlarged left ventricle.
Findings:
- Serum calcium levels were critically low, indicating undiagnosed hypocalcemia.
- Therapeutic correction of hypocalcemia led to dramatic improvement in ventricular wall motion.
- Left ventricular size significantly decreased following normalization of serum calcium.
Implications:
- Hypocalcemia should be considered in the differential diagnosis of unexplained cardiomyopathies.
- Prompt diagnosis and treatment of hypocalcemic cardiomyopathy can reverse cardiac dysfunction.
- Calcitriol is identified as the treatment of choice for correcting calcium deficiency in hypocalcemic cardiomyopathy.
Abstract:
The authors report the clinical history of a 56-year-old man with cardiomyopathy due to undiagnosed hypocalcemia. Heart dilation and hypokinesia were assessed by echocardiography. Cardiac failure was refractory to digitalis preparations and to diuretics. The restoration of serum calcium to normal levels obtained with adequate therapy dramatically improved the motion of ventricular walls and decreased the size of the left ventricle. The pathogenetic mechanisms of hypocalcemic cardiomyopathy are discussed and the importance of considering the possibility of hypocalcemia when dealing with the differential diagnosis of cardiomyopathies is underlined. In the presence of hypocalcemic cardiomyopathy, the correction of calcium deficiency with calcitriol is the treatment of choice.