Endocrine Abstracts

Introduction: Clinical manifestations of hypocalcaemia vary from very mild and asymptomatic biochemical abnormality to severe life-threatening disorders. Heart failure due to hypocalcaemia is refractory to conventional treatment. Many clinicians may be unaware of hypocalcaemia associated with heart failure, since it is often ignored. Hypocalcaemia heart failure is a rare and potentially reversible disturbance, The decompensated heart failure is rapidly reversed by aggressive calcium supplementation.

Case report: We report a 16-year-old female with previous history of convulsions who developed cardiac failure due to hypocalcaemia. Echocardiography showed left ventricular dilatation, global hypokinesia, mild systolic dysfunction (ejection fraction 35%), moderate pericardial effusion. Low serum calcium mild hyperphosphateamia, elevated alkaline phosphates, and elevated PTH. After aggressive treatment of hypocalcaemia by calcium infusion–vitamin D supplementation, signs and symptoms of heart failure dramatically improved with almost full recovery of left ventricular function (67% ejection fraction after 16 days of the initial echo) The patient was discharged under stable conditiond with calcium carbonate, calcitriol.with follow-up clinically and echocardiographically stable.

Conclusion: We conclude that in a young patient a thorough investigation for heart failure is never complete without looking for endocrine and metabolic causes. Serum calcium level should be monitored in every patient with cardiac failure and hypocalcemia should be considered in patients with refractory heart failure.

Keywords: Heart failure; hypocalcaemia pseudo hypoparathyroidism