Lam José, Maragaño Patricio, Lépez Bárbara, Vásquez Loreto
Servicio de Medicina, Hospital Regional de Talca, Talca, Chile.
Rev Med Chil. 2007 Mar;135(3):359-64. Epub 2007 Apr 26.
Calcium plays a central role in ventricular function. We report a 37 year-old woman with chronic hypoparathyroidism and hypocalcemia secondary to a thyroidectomy performed when she was 18 years old, as treatment for a Graves Basedow's disease. She did not have previous cardiac symptoms and rapid progressive congestive heart failure developed after the beginning of levothyroxin supplementation for post operative hypothyroidism. Echocardiography revealed severe systolic and diastolic left ventricular dysfunction, mitral and tricuspid valve insufficiency, systolic pulmonary hypertension, left atrial enlargement and pericardial effusion. Calcium supplementation in addition to diuretics, captopril and digoxin were followed by rapid clinical improvement. Follow up until 18 months showed persistent left ventricular dilatation and systolic dysfunction, with improvement of all the other echocardiographic findings.
钙在心室功能中起着核心作用。我们报告了一名37岁女性,她患有慢性甲状旁腺功能减退症和低钙血症,继发于18岁时因格雷夫斯病(Graves Basedow's disease)接受的甲状腺切除术。她既往无心脏症状,在开始补充左甲状腺素治疗术后甲状腺功能减退后,迅速出现进行性充血性心力衰竭。超声心动图显示严重的左心室收缩和舒张功能障碍、二尖瓣和三尖瓣关闭不全、收缩期肺动脉高压、左心房扩大和心包积液。除利尿剂、卡托普利和地高辛外补充钙后,临床症状迅速改善。随访至18个月时,左心室持续扩张和收缩功能障碍,其他所有超声心动图表现均有改善。