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A case of severe hypocalcaemia mimicking myocardial infarction
L S Rallidis1, P P Gregoropoulos, E G Papasteriadis
1Cardiology Department, General Hospital of Nikea, Piraeus, Greece.
Insights
Chronic hypocalcaemia can lead to severe heart dysfunction, mimicking heart attacks. Prompt treatment of hypocalcaemia, caused by hypoparathyroidism, can reverse advanced cardiomyopathy, restoring near-normal cardiac function.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Bone Disease
Background:
- Long-standing hypocalcaemia, often resulting from untreated hypoparathyroidism, poses significant health risks.
- Congestive heart failure is a known, albeit less common, complication of chronic low calcium levels.
Observation:
- A 46-year-old woman with chronic severe hypocalcaemia due to untreated hypoparathyroidism presented with severe heart dysfunction.
- Her initial presentation, characterized by specific biochemical, electrocardiographic, and echocardiographic findings, led to a misdiagnosis of acute myocardial infarction.
Findings:
- The patient's cardiac function significantly improved, returning to near-normal levels within months of correcting her hypocalcaemia.
- This clinical course highlights the direct impact of calcium levels on myocardial function.
Implications:
- Advanced cardiomyopathy secondary to hypocalcaemia is potentially reversible with appropriate treatment.
- This case underscores the importance of considering and diagnosing hypoparathyroidism in patients with unexplained cardiac dysfunction.
- Timely diagnosis and management of hypoparathyroidism can prevent severe cardiac complications and improve patient outcomes.
Abstract:
Long-standing hypocalcaemia can be complicated by congestive heart failure. We report a 46-year-old woman with chronic severe hypocalcaemia due to untreated hypoparathyroidism. This patient developed severe heart dysfunction but when first presented was misdiagnosed as acute myocardial infarction based mainly on the biochemical, electrocardiographic and echocardiographic findings. The near-normal cardiac function a few months after the correction of hypocalcaemia demonstrates that even advanced forms of cardiomyopathy are potentially reversible with treatment of hypoparathyroidism.