Endocrinol Metab.  2011 Sep;26(3):268-271. 10.3803/EnM.2011.26.3.268.

Reversible Heart Failure and Rhabdomyolysis Caused by Primary Hypoparathyroidism during Lactation

• Jung K
• Choi JH
• Kim HJ
• Chung HK
• Kim D

• KMID: 2169181
• DOI: http://doi.org/10.3803/EnM.2011.26.3.268

Abstract

Hypocalcemia can be complicated, on rare occasions, by congestive heart failure and may also be associated with labor and lactation in some cases. Herein, we report a 30-year-old woman with hypocalcemia-induced heart failure secondary to primary idiopathic hypoparathyroidism precipitated by lactation. The patient presented with chest pain and paresthesia in both arms and legs during breast-feeding after her second delivery. She had severe hypocalcemia and low parathyroid hormone levels. Hypocalcemia-induced rhabdomyolysis further aggravated her hypocalcemia symptoms. The echocardiogram showed global hypokinesia with an ejection fraction of 47%. After calcium and vitamin D replacement, her symptoms and ventricular function improved. Hypocalcemia needs to be considered in patients with heart failure, because it is readily reversible. To the best of our knowledge, this is the first report of a patient with heart failure and rhabdomyolysis induced by primary hypoparathyroidism during lactation.

Keyword

Heart failure; Hypocalcemia; Hypoparathyroidism

MeSH Terms

Adult
Arm
Calcium
Chest Pain
Female
Heart
Heart Failure
Humans
Hypocalcemia
Hypokinesia
Hypoparathyroidism
Lactation
Leg
Parathyroid Hormone
Paresthesia
Rhabdomyolysis
Ventricular Function
Vitamin D
Calcium
Parathyroid Hormone
Vitamin D

Figure

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  Fig. 1 Baseline electrocardiogram showed sinus rhythm, T wave inversion in leads V1-6, II, III, and aVF, and a prolonged QT interval of 0.397 seconds.

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  Fig. 2 Follow-up electrocardiogram at 2 months after treatment showed that T wave inversion as seen on Figure 1 disappeared and QT intervals normalized.

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