Hypocalcemia precipitating congestive heart failure

A case study is reported for a 76 year-old black female hospital patient being treated without success for congetive heart failure using conventional therapy. This case was analogous to several previous cases in which an elderly patient with hypoparathyroidism became refractory to conventional therapy for congestive heart failure following hypocalcemia; heart failure was resolved only when the hypocalcemia was corrected. In the present case study, it was determined that the patient's underlying hypertensive and atherosclerotic disease was probably the major factor causing impaired cardiac function. Nonetheless, the episodes of severe congestive heart failure appeared to be precipitated and prolonged by chronic hypocalcemia. These observations indicate that, in patients with unexplained or refractory heart failure, the possibility of unrecognized hypocalcemia as a contributing factor should be considered in diagnosis and therapy programs. (wz)