J Cardiovasc Ultrasound.  2010 Mar;18(1):25-27. 10.4250/jcu.2010.18.1.25.

A Case of Hypocalcemia-Induced Dilated Cardiomyopathy

• Sung JK
• Kim JY
• Ryu DW
• Lee JW
• Youn YJ
• Yoo BS
• Choe KH

• KMID: 1457202
• DOI: http://doi.org/10.4250/jcu.2010.18.1.25

Abstract

Hypocalcemia is a rare cause of dilated cardiomyopathy. Hypocalcemia induced cardiomyopathy is usually reversible when calcium level returns to normal range. We experienced a case of 57-year-old woman who had suffered from hypocalcemia after total thyroidectomy and its consequence of dilated cardiomyopathy. After supplementation of calcium and vitamin D, symptoms of heart failure and LV function were recovered.

Keyword

Hypocalcemia; Dilated cardiomyopathy

MeSH Terms

Calcium
Cardiomyopathies
Cardiomyopathy, Dilated
Female
Heart Failure
Humans
Hypocalcemia
Middle Aged
Reference Values
Thyroidectomy
Vitamin D
Calcium
Vitamin D

Figure

• 

  Fig. 1 Chest radiography on admission revealed cardiomegaly and increased pulmonary vascularity in both lung filed (A). Cardiomegaly and pulmonary congestion improved on follow up at 5 months after medical treatment (B).

• 

  Fig. 2 Transthoracic echocardiography on admission revealed increased left ventricular end diastolic dimension (6.8 cm) and 37% of left ventricular ejection fraction (EF) (A). Mitral inflow diastolic pattern showed restrictive physiology with E/A ratio was 2.94 (B). LV ejection fraction and LV end-diastolic dimension was normalized (C), and transmital inflow patterns was improved from restrictive physiology (E/A ratio: 2.94) to abnormal relaxation pattern (E/A ratio: 0.69) (D).

Reference

1. Bers DM. Cardiac excitation-contraction coupling. Nature. 2002. 415:198–205.

2. Avsar A, Abdullah D, Taveli T. A rare cause of reversible dilated cardiomyopathy: hypocalcemia. Echocardiography. 2004. 21:609–612.

3. Avramides DA, Ionitsa SS, Panou FK, Ramos AN, Koutmos ST, Zacharoulis AA. Dilated Cardiomyopathy and Hypoparathyroidism: Complete Recovery after Hypocalcemia Correction. Hellenic J Cardiol. 2003. 44:150–154.

4. Jayakuma A, Cheng L, Liang CT, Sacktor B. Sodium gradient-dependent calcium uptake in renal basolateral membrane vesicles. Effect of parathyroid hormone. J Biol Chem. 1984. 259:10827–10833.

5. Giles TD, Iteld J, Rives KL. The cardiomyopathy of hypoparathyroidism. Another reversible form of heart muscle disease. Chest. 1981. 79:225–229.

6. Pallidis LS, Gregoropoulos PP, Papasteriadis EG. A case of severe hypocalcemia mimicking myocardial infarction. Int J Cardiol. 1997. 61:89–91.

7. Walters RO. Idiopathic hypoparathyroidism with extrapyramidal and myopathy features. Arch Dis Child. 1979. 54:236–238.

8. Breslau NA, Pak CY. Hypoparathyroidism. Metabolism. 1979. 28:1261–1276.

9. Gurtoo A, Goswami R, Singh B, Rehan S, Meena HS. Hypocalcemia-induced reversible hemodynamic dysfunction. Int J Cardiol. 1994. 43:91–93.