. 1998; 26(5): 310-312

Olgu Bildirileri Kalp Yetersizliğinin Nadir Bir Sebebi: Hipokalsemik Kardiyomiyopati

Mustafa KAHRAMAN1, Murat MOGULKOÇ1, Hazım DİNÇER1, Can ÖZER1
Bayındır Tıp Merkezi, Ankara

Onbeş yıl önce tiroid kanseri nedeni ile opere edilen 29 yaşındaki kadın hasta 3 yıl önce konjestif kalp yetersizliği nedeni ile hastaneye yatırıldı. O zamandan beri tiroid replasman tedavisi ve oral kalsiyum alıyordu. Ekokardiyografik incelemede ejeksiyon fraksiyonu %28 ve sol ventrikülü geniş bulundu. Medikal tedavi ile semptomların düzelmesine rağmen, 6 ay önce hipokalsemik tetani nedeni ile tekrar yatırıldı. Kalsiyum dozu arttırıldı ve tedaviye D vitamini eklendi. Ejeksiyon fraksiyonu % 58'e kadar yükseldi, sadece kalsiyum ve D vitaminin almasına rağmen, asemptomatik kalan hastada, fizik ve ekokardiyografik bulgular tamamen normale döndü. Kronik hipokalsemi reversibl ciddi sol ventrikül disfonksiyon yapabilir.



A Rare Cause of Heart Failure: Hypocalcemic Cardiomyopathy

Mustafa KAHRAMAN1, Murat MOGULKOÇ1, Hazım DİNÇER1, Can ÖZER1

Hypocalcemia is a relatively uncommon but reversible cause of congestive heart failure. A 29- year-old woman, admitted to the hospital due to congestive heart failure, was operated for thyroid gland carcinoma fifteen years ago. She was taking oral calcium and thyroid replacement therapy after the operation. Her ejection fraction was 28% and she had no evidence of underlying cardiac disease. Symptoms subsided with medical treatment, but no echocardiographic improvement was observed in Ieft ventricular size and functions. She was admitted to the hospital again in hypocalcemic tetany state six months ago. The dosage of calcium was increased and Vit D added to her medications. Two months later, she was completely asymptomatic and her ejection fraction was 58% in echocardiographic examination. This time heart failure medications was stopped and she continued to take only calcium and Vit D. Three months later she was again asymptomatic, her physical and echocardiographic examination were completely normal. Chronic hypocalcemia can cause severe left ventricular dysfunction. This elinical situation, namely hypocalcemic cardiomyopathy, though in some cases long-lasting, can be reverted by calcium replacement.



Mustafa KAHRAMAN, Murat MOGULKOÇ, Hazım DİNÇER, Can ÖZER. A Rare Cause of Heart Failure: Hypocalcemic Cardiomyopathy. . 1998; 26(5): 310-312


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