Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10659-10665
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10659
Reversible congestive heart failure associated with hypocalcemia: A case report
Chu Wang, Li-Wen Dou, Tian-Bing Wang, Yang Guo
Chu Wang, Tian-Bing Wang, Yang Guo, Trauma Rescue & Treatment Center, Peking University People's Hospital, Beijing 100044, China
Li-Wen Dou, Emergency Department, Peking University People's Hospital, Beijing 100044, China
Author contributions: Wang C and Dou LW contributed equal efforts to this work; Wang C contributed to manuscript drafting and editing; Dou LW was the attending doctor of the patient, reviewed the literature, and contributed to manuscript editing; Wang TB contributed to manuscript supervision; Guo Y was the chief physician of the patient and contributed to manuscript conception and supervision.
Supported by National Key R&D Program of China, No. 2018YFF0301103.
Informed consent statement: Written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yang Guo, MD, Doctor, Trauma Rescue & Treatment Center, Peking University People's Hospital, No. 11 Xizhimen South Boulevard, Xicheng District, Beijing 100044, China. edguoyang@163.com
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: May 11, 2021
Revised: May 17, 2021
Accepted: October 27, 2021
Article in press: October 27, 2021
Published online: December 6, 2021
Processing time: 276 Days and 21.3 Hours
Abstract
BACKGROUND

Hypoparathyroidism is a rare disease that may occur due to primary or secondary etiologies. The estimated incidence in the United States is 24–37/100000 person-years. Congestive heart failure associated with hypocalcemia due to hypoparathyroidism is an even rarer presentation.

CASE SUMMARY

Here, we present a 64-year-old woman with congestive heart failure following hypocalcemia. The patient was transferred to our emergency department with complaints of rapidly progressive dyspnea, shortness of breath and heaviness of the chest for 4 d. She had a history of undergoing thyroidectomy and partial tracheotomy 2 years prior due to a malignant thyroid tumor. Muscle spasms had been present 1 year ago, and cataracts were treated with intraocular lens replacement in both eyes. Most tests were within normal ranges, except serum calcium at 1.33 mmol/L (2.20–2.65 mmol/L), ionized calcium at 0.69 mmol/L (1.15–1.29 mmol/L), and parathyroid hormone at < 1.0 pg/mL (12–88 pg/mL). Echocardiography revealed an ejection fraction of 28.48%. Cardiac function was quickly reversed by restoring the serum calcium concentration. Significant improvements were noted with an ejection fraction of up to 48.50% at follow-up.

CONCLUSION

For patients with potential hypocalcemia, monitoring calcium levels and dealing with hypocalcemia in time to avoid serious complications are important.

Keywords: Hypoparathyroidism; Congestive heart failure; Cardiomyopathy; Parathyroid hormone; Calcium; Echocardiography; Case report

Core Tip: Hypoparathyroidism-related cardiomyopathy is rare but reversible. We present a rare case of congestive heart failure associated with hypocalcemia in an elderly female with a history of thyroidectomy. The heart failure was reversed rapidly by infusion of calcium gluconate. With the supplementation of calcium, the cardiac function was maintained very well. The patient also presented with a history of cataracts. This case highlights that, for patients with potential hypocalcemia, we need to supplement calcium and closely monitor calcium levels to manage the hypocalcemia in time to avoid serious complications, such as cardiac complications or cataracts.