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Primary hyperparathyroidism with cardiac abnormalities: a case report

C Y Yang1, C C Cheng, C W Chou

  • 1Division of Endocrinology and Metabolism, Chi-Mei Foundation Hospital, Tainan, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|March 24, 1998
PubMed
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Primary hyperparathyroidism can cause serious heart problems, including valvular calcification. This case highlights the link between parathyroid hormone excess and cardiovascular complications in the elderly.

Area of Science:

  • Endocrinology
  • Cardiology
  • Geriatrics

Background:

  • Primary hyperparathyroidism (PHP) is common in the elderly, often presenting with hypercalcemia and hypophosphatemia.
  • PHP is associated with various cardiovascular abnormalities, including valvular heart disease, arrhythmias, and hypertension.

Observation:

  • An 82-year-old male presented with symptoms of chest discomfort, fatigue, and weakness.
  • Biochemical tests revealed hypercalcemia (14.3 mg/dl) and elevated parathyroid hormone (PTH-intact: 705 pg/ml).
  • Echocardiography showed severe aortic valvular calcification, aortic regurgitation, mitral regurgitation, and myocardial calcification.

Findings:

  • The patient was diagnosed with primary hyperparathyroidism and parathyroid adenoma.
  • Parathyroidectomy was performed, followed by symptomatic hypocalcemia requiring calcium and vitamin D supplementation.

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  • Post-surgery echocardiography revealed no improvement in valvular calcification.

    • Implications:

    • This case underscores the significant cardiovascular manifestations of primary hyperparathyroidism, particularly valvular calcification.
    • Early diagnosis and management of PHP are crucial to potentially mitigate severe cardiac complications.
    • Further research is needed to understand the long-term impact of PHP on valvular health and the efficacy of treatment.