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A case of massive pericardial effusion associated with hypocalcemic cardiomyopathy

Tetsuro Yokokawa1, Keiji Sakamoto1, Hiroyuki Mizuno1

  • 1Department of Cardiology, Hoshi General Hospital, Koriyama, Japan.

Journal of Cardiology Cases
|December 15, 2018
PubMed

Insights

Hypocalcemia, a rare cause of heart failure, can lead to reduced ejection fraction and pericardial effusion. Prompt calcium replacement therapy can significantly improve cardiac function in these patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Heart failure and pericardial effusion are serious conditions often requiring complex management.
  • Idiopathic hypoparathyroidism is an endocrine disorder characterized by insufficient parathyroid hormone production, leading to low calcium levels.

Observation:

  • A 60-year-old woman presented with dyspnea, numbness, elevated creatine kinase, and ECG abnormalities, indicative of cardiac distress.
  • Investigations revealed reduced left ventricular ejection fraction (LVEF) and massive pericardial effusion, leading to a heart failure diagnosis.
  • Further testing identified hypocalcemia and idiopathic hypoparathyroidism as underlying causes.

Findings:

  • Calcium replacement therapy, alongside diuretics, successfully improved LVEF and reduced pericardial effusion.
  • This case highlights the potential for severe cardiac manifestations, including heart failure and pericardial effusion, secondary to hypocalcemia.

Implications:

  • Hypocalcemia should be considered in the differential diagnosis of heart failure with reduced ejection fraction and massive pericardial effusion.
  • Numbness, elevated creatine kinase, T wave inversion, and prolonged QT interval can serve as supportive diagnostic indicators for hypocalcemia-induced heart failure.

Keywords:
Heart failureHypocalcemiaHypocalcemic cardiomyopathyIdiopathic hypoparathyroidismPericardial effusion

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