A case of hypocalcemia, heart failure and exceptional repolarization disturbances.

Little attention has been given to the question whether clinical heart failure can be a manifestation of hypocalcemia. A patient with hypoparathyroidism and heart failure prompted us to analyse the reports on this subject. The conclusion was that if associated with an underlying myocardial disease, hypocalcemia may be a rare contributing factor to hear failure. Hypocalcemic heart failure without coexisting heart disease has been suggested as a cause of hypotension in two special situations in which a sudden fall of serum ionized calcium is induced: massive transfusions of citrated blood and rapid correction of uremic acidosis. In addition to hypocalcemia and heart failure, our patient had exceptional repolarization disturbances: rate-dependent variation of T wave amplitudes during sinus arrhythmia and unexpected prolongations of the Q-T interval with attacks of ventricular tachycardia.