Korean Circ J.  2013 Aug;43(8):573-577. 10.4070/kcj.2013.43.8.573.

Takotsubo Cardiomyopathy Associated with Severe Hypocalcemia Secondary to Idiopathic Hypoparathyroidism

• Rhee HS
• Lee SW
• Jung YK
• Jeon U
• Park SH
• Lee SJ
• Sin WY
• Jin DK

• KMID: 2224850
• DOI: http://doi.org/10.4070/kcj.2013.43.8.573

Abstract

The etiology and pathophysiology of takotsubo cardiomyopathy have not yet been fully clarified. We report a case of takotsubo cardiomyopathy associated with severe hypocalcemia secondary to hypoparathyroidism. A 69-year-old woman presented with acute pulmonary edema caused by severe left ventricular dysfunction with apical ballooning compatible with takotsubo cardiomyopathy. Laboratory tests revealed severe hypocalcemia secondary to idiopathic hypoparathyroidism. Coronary angiography showed normal coronary artery function. Her symptoms and signs of heart failure improved dramatically with the correction of hypocalcemia through calcium and calcitriol replacement.

Keyword

Takotsubo cardiomyopathy; Hypocalcemia; Hypoparathyroidism

MeSH Terms

Aged
Calcitriol
Calcium
Coronary Angiography
Coronary Vessels
Female
Heart Failure
Humans
Hypocalcemia
Hypoparathyroidism
Pulmonary Edema
Takotsubo Cardiomyopathy
Ventricular Dysfunction, Left
Calcitriol
Calcium

Figure

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  Fig. 1 Echocardiography (left; diastolic phase, right; systolic phase) prior to treatment, showing enlarged left ventricle with apical ballooning and severe mid-segment hypokinesia during systole, sparing basal segment.

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  Fig. 2 Coronary angiography showing nearly normal coronary artery.

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  Fig. 3 Left ventriculogram during systole (left) and diastole (right), performed on the fourth day of admission. Note the markedly improved left ventricular contractility and apical ballooning with focal residual wall motion abnormality on the mid to apical antero-septal wall.

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  Fig. 4 Echocardiography (left; diastolic phase, right; systolic phase) after treatment, showing complete improvement of the dimension and contractility of the left ventricle.

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