Severe hypocalcaemia presenting as reversible hypokinetic cardiomyopathy

Dilated cardiomyopathy may be primary or secondary. Although some causes ar e well known, such as toxic substances (alcohol, chemotherapy...) or viral infections, biochemical abnormalities are much less common. The authors report the case of a 58 year old woman with no previous history , admitted to hospital for an inaugural episode of cardiac failure. The ECG showed sinus tachycardia with a long QT interval (560 mm) and a dilated hy pokinetic cardiomyopathy with a left ventricular ejection fraction of 20%. The aetiological investigation showed severe hypocalcaemia (0.66 mmol/L) re lated to primary hypoparathyroidism. This is an important cause to remember because its treatment leads to corre ction of the cardiac disease, usually within weeks.