Korean Circ J.  2010 Apr;40(4):201-203. 10.4070/kcj.2010.40.4.201.

Dilated Cardiomyopathy in a 2 Month-Old Infant: A Severe Form of Hypocalcemia With Vitamin D Deficient Rickets

• Kim BG
• Chang SK
• Kim SM
• Hwang JS
• Jung JW

• KMID: 2145558
• DOI: http://doi.org/10.4070/kcj.2010.40.4.201

Abstract

Dilated cardiomyopathy, which mostly has an idiopathic etiology or is caused by genetic inheritance or infection, can cause irreversible congestive heart failure. Hypocalcemia is a rare etiology of reversible dilated cardiomyopathy. Here we report the case of a two-month-old girl with congestive heart failure who was diagnosed as having dilated cardiomyopathy secondary to hypocalcemia. After calcium and vitamin D replacement therapy, the patient showed a rapid reduction in hypocalcemic tetany and a rapid recovery of left ventricular function. The cause of the hypocalcemia was vitamin D deficient rickets. She was exclusively breast-fed as an infant, and her mother had a vitamin D deficiency and was diagnosed with osteomalacia.

Keyword

Dilated cardiomyopathy; Congestive heart failure; Vitamin D deficiency; Hypocalcemia; Rickets

MeSH Terms

Calcium
Cardiomyopathy, Dilated
Heart Failure
Humans
Hypocalcemia
Infant
Mothers
Osteomalacia
Rickets
Tetany
Ventricular Function, Left
Vitamin D
Vitamin D Deficiency
Vitamins
Wills
Calcium
Vitamin D
Vitamins

Figure

• 

  Fig. 1 Initial chest. This initial chest X-ray shows an apparent cardiomegaly and pulmonary congestion. The cardiothoracic ratio was 0.64.

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  Fig. 2 Initial echocardiogram. The initial echocardiogram shows a markedly enlarged left ventricle and hypokinetic ventricular wall motion with an ejection fraction of 17%, and a fractional shortening as 8%.

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  Fig. 3 Initial ECG. The initial electrocardiogram showed sinus tachycardia (a heart rate of 191 beat/min), a PR interval of 0.170 seconds, and a normal QTc (0.415 seconds).

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  Fig. 4 Follow-up chest X-ray. There was no pulmonary congestion and no cardiomegaly. The cardiothoracic ratio was reduced to 0.53.

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  Fig. 5 Follow-up echocardiogram. Ejection fraction and fractional shortening were 66% and 35%, respectively. There was normal symmetric wall motion.

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