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Case report: A case of hypocalcemic cardiomyopathy with non-reversible cardiac fibrosis
Ying Xie1, Jing Yang1, Kun Li1
1Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Insights
Hypocalcemic cardiomyopathy, a rare cause of heart failure, is typically reversible. This case highlights potential non-reversible cardiac fibrosis despite initial recovery, necessitating ongoing monitoring and cardioprotective agents.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Hypocalcemic cardiomyopathy is a rare cause of heart failure, often presenting with reversible left ventricular dysfunction.
- Patients with a history of thyroidectomy are at increased risk for hypocalcemia.
Observation:
- A 52-year-old female presented with acute decompensated heart failure and hypocalcemia symptoms post-thyroidectomy.
- Initial treatment with diuresis and electrolyte correction led to rapid improvement in heart failure symptoms.
Findings:
- Echocardiography showed significant improvement in left ventricular ejection fraction (27% to 53%) and dimensions.
- However, 1-year follow-up with cardiac MRI revealed persistent, non-reversible cardiac fibrosis, indicating potential long-term myocardial damage.
Implications:
- This case underscores the importance of recognizing hypocalcemic cardiomyopathy as a treatable cause of heart failure.
- Despite initial reversibility, persistent cardiac fibrosis may occur, warranting long-term monitoring and cardioprotective strategies in affected patients.
Abstract:
Hypocalcemic cardiomyopathy is a rare etiology of heart failure. It is considered highly reversible with a relatively favorable prognosis. This case reports a 52-year-old housewife diagnosed with hypocalcemic cardiomyopathy who presented with acute decompensated heart failure and hypocalcemia symptoms with a history of thyroidectomy. Shortness of breath and edema were relieved after diuresis and prompt electrolyte correction. The left ventricular ejection fraction increased from 27% to 53%, and the left ventricular end-diastolic dimension shortened from 58 to 50 mm in echocardiographic re-examinations, while repeat cardiac magnetic resonance imaging revealed evidence of non-reversible cardiac fibrosis after 1-year follow-up. Cardioprotective agents with close follow-ups were called for in this entity of patients.
