Dual etiology of dilated cardiomyopathy: the synergistic role of vitamin D deficiency.

Dilated cardiomyopathy is the commonest form of cardiomyopathy in pediatric patients. Various causal factors have been identified, including ionic imbalance. Calcium ions play an essential role in regulating myocardial contractile function, and the harmful role of hypocalcemia as a coadjuvant or even precipitating factor of worsening heart failure has been described in rare case reports. Multiple causative factors may occasionally be present. We describe the first case, to our knowledge, of dilated cardiomyopathy in an infant with severe hypocalcemia and viral myocarditis.