Reversible heart failure secondary to hypocalcemia in a post-thyroidectomy patient: a rare case report

Heart failure (HF) is a complex syndrome that is primarily caused by structural or functional abnormalities of the heart; however, metabolic disturbances such as hypocalcemia can significantly contribute. We report a case of hypocalcemia-induced HF following total thyroidectomy in a 52-year-old woman. It underscores the reversible nature of hypocalcemia-induced cardiomyopathy and illustrates the sequential progression and resolution of HF with appropriate calcium supplementation and medical management.

A 52-year-old woman developed HF due to severe hypocalcemia following total thyroidectomy for papillary thyroid carcinoma. Treatment with calcium supplementation and cardiac medications led to significantly improved cardiac function over time. Follow-up evaluations revealed a sustained recovery in cardiac function, evidenced by gradual improvement in left ventricular ejection fraction, reaching 50% at 1-year and 60% at 3-year follow-ups, corroborating the reversible nature of hypocalcemia-induced HF.

Primary hypoparathyroidism results in low parathyroid hormone levels, commonly leading to hypocalcemia, a reversible cause of HF. Hypocalcemia disrupts cardiac muscle contraction and relaxation by affecting calcium ions, which are crucial for excitation-contraction coupling. This case highlights acute HF due to severe hypocalcemia, emphasizing the importance of considering endocrine causes in cases of unexplained HF. Prompt treatment with calcium supplementation can reverse hypocalcemia-induced cardiomyopathy, supporting the need for the early identification and management of hypocalcemia in post-thyroidectomy patients to prevent cardiac dysfunction.

Prompt evaluation and correction of hypocalcemia in hypocalcemia-induced HF patients is vital for improving cardiac function, patient outcomes, and ensuring optimal management.