Baqi Dana H, Ahmed Shaho F, Baba Hiwa O, Fattah Fattah H, Salih Abdulwahid M, Ali Rawa M, Saed Darko H Amin H, Kakamad Fahmi H
College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq.
Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
Ann Med Surg (Lond). 2022 Apr 5;77:103572. doi: 10.1016/j.amsu.2022.103572. eCollection 2022 May.
In both pediatric and adult populations, hypocalcemia-induced heart failure is an extremely rare presentation. The aim of the current study is to report a case of reversible heart failure caused by severe hypocalcemia resulting from hypoparathyroidism, which was resolved by correcting the serum calcium level.
A 29-year-old female presented with orthopnea, dyspnea on mild exertion, and bilateral lower limb swelling. She had a positive Trousseau's sign. Vital signs were stable except for tachycardia. On chest auscultation, there were bilateral basal fine inspiratory crackles. She was immediately treated as a case of pulmonary edema with intravenous furosemide and oxygen therapy. Subsequent treatment for correcting the hypocalcemia was then initiated.
Hypocalcemia has been proven to influence cardiac function, resulting in lower cardiac contractility as determined by decreased left ventricular work index, stroke index, and cardiac index. In rare circumstances, the clinical, biochemical (elevation of cardiac enzymes), electrocardiographic, and echocardiographic data may lead to an incorrect diagnosis of an acute ischemic attack.
Hypocalcemia as a possible factor leading to heart failure should be considered in the differential diagnosis of all individuals with congestive heart failure.
在儿科和成人患者中，低钙血症诱发的心力衰竭极为罕见。本研究旨在报告一例由甲状旁腺功能减退导致的严重低钙血症引起的可逆性心力衰竭病例，该病例通过纠正血清钙水平得以解决。
一名29岁女性出现端坐呼吸、轻度活动时呼吸困难及双侧下肢肿胀。她有陶瑟征阳性。除心动过速外，生命体征稳定。胸部听诊时，双侧肺底部可闻及细湿啰音。她立即被当作肺水肿病例接受静脉注射速尿和氧疗。随后开始进行纠正低钙血症的治疗。
低钙血症已被证实会影响心脏功能，导致心脏收缩力下降，这可通过左心室作功指数、每搏输出指数和心脏指数降低来确定。在罕见情况下，临床、生化（心肌酶升高）、心电图和超声心动图数据可能导致对急性缺血发作的误诊。
在所有充血性心力衰竭患者的鉴别诊断中，应考虑低钙血症作为导致心力衰竭的一个可能因素。
