A Rare Cause of Heart Failure: Hypocalcemic Cardiomyopathy

Hypocalcemia is a relatively uncommon but reversible cause of congestive heart failure. A 29- year-old woman, admitted to the hospital due to congestive heart failure, was operated for thyroid gland carcinoma fifteen years ago. She was taking oral calcium and thyroid replacement therapy after the operation. Her ejection fraction was 28% and she had no evidence of underlying cardiac disease. Symptoms subsided with medical treatment, but no echocardiographic improvement was observed in Ieft ventricular size and functions. She was admitted to the hospital again in hypocalcemic tetany state six months ago. The dosage of calcium was increased and Vit D added to her medications. Two months later, she was completely asymptomatic and her ejection fraction was 58% in echocardiographic examination. This time heart failure medications was stopped and she continued to take only calcium and Vit D. Three months later she was again asymptomatic, her physical and echocardiographic examination were completely normal. Chronic hypocalcemia can cause severe left ventricular dysfunction. This elinical situation, namely hypocalcemic cardiomyopathy, though in some cases long-lasting, can be reverted by calcium replacement.