Chandrakant B. Chavan, MD, DNB; Kalavakolanu Sharada, MD, DM; Hygriv B. Rao, MD, DM; Calambur Narsimhan, MD, DM, AB
Acknowledgment: The authors thank Dr. Leonard J. Deftos, University of California, San Diego, for help with revising the paper.
Potential Financial Conflicts of Interest: None disclosed.
Chavan C., Sharada K., Rao H., Narsimhan C.; Hypocalcemia as a Cause of Reversible Cardiomyopathy with Ventricular Tachycardia. Ann Intern Med. 2007;146:541-542. doi: 10.7326/0003-4819-146-7-200704030-00020
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Published: Ann Intern Med. 2007;146(7):541-542.
Background: Hypocalcemia is a rare cause of heart failure.
Objective: To describe a case of severe refractory heart failure caused by vitamin D deficiency and hypocalcemia.
Case Report: A 48-year-old male physician with diabetes and hypertension was referred to our institution for insertion of an implantable cardioverter-defibrillator. He had New York Heart Association class IV heart failure symptoms at presentation, including recurrent episodic palpitations with presyncope and increasing breathlessness over 2 months. He had no history of fever. On examination, his temperature was 36.8 °C, pulse was 92 beats/min, arterial blood pressure was 110/70 mm Hg, and respiratory rate was 34 breaths/min. He had a left ventricular (LV) third heart sound (S3). Chest radiography on admission showed cardiomegaly and pulmonary venous hypertension (Figure 1). He had recurrent episodes of monomorphic and polymorphic ventricular tachycardia (VT) (Figure 2). Baseline 12-lead electrocardiography during sinus rhythm showed a corrected QT interval of 500 ms. Serum C-reactive protein levels and erythrocyte sedimentation rate were normal. Left ventricular function assessed by echocardiography during sinus rhythm revealed severe LV systolic dysfunction and global LV hypokinesia.
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