Heart Failure and Neonatal Hypocalcaemia

Troughton, O.; Singh, Shyam

doi:10.1136/bmj.4.5832.76

Cited by 31 publications

(12 citation statements)

References 12 publications

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“…Hypocalcemia is a relatively uncommon, but reversible cause of congestive heart failure. Several case reports of hypocalcemiainduced cardiomyopathy have appeared in the literature; however, most were in neonates and adults with other complicating diseases affecting myocardial contractility [1,2,4,5,8,18,19]. None of our patients showed overt signs or symptoms of cardiac failure.…”

Section: Discussioncontrasting

confidence: 44%

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Cardiac Functions in Children with Vitamin D Deficiency Rickets

1999

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Nutritional deficiency of vitamin D is common in developing countries as a result of both inadequate diet and exposure to ultraviolet light. The most striking biochemical finding in this illness is hypocalcemia. Reduction in serum calcium level may affect ventricular contraction. The purpose of this study was to evaluate prospectively left ventricular function in a group of 27 infants diagnosed as having rickets. Electrocardiograms and echocardiographic studies were undertaken in all patients. A group of ten healthy infants was used as a control for the echocardiographic examinations. Patients were divided into three groups according to the biochemical classification of rickets. There were eight patients in group I, nine in group II, and ten in group III. Abnormal electrocardiographic findings were noted in four infants in group I, three in group II, and six in group III before treatment of the rickets. These changes resolved following treatment. Echocardiographic studies revealed left ventricular dysfunction in the pretreatment stage. The most striking echocardiographic finding is the increase in the ratio of interventricular septal thickness to left ventricular posterior wall thickness in eight patients from group III. This returned to normal after treatment of the rickets. This study has demonstrated echocardiographic evidence of left ventricular dysfunction in children with rickets. These abnormalities were not, however, sufficiently severe to be associated with clinical signs of cardiac failure. Cardiomyopathy may develop in rickets, especially in the third stage of the disease, and this finding may return to normal following adequate treatment of the rickets.

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Section: Discussioncontrasting

confidence: 44%

“…It is essential for excitation-contraction coupling in the cardiac muscle. Cardiac dysfunction occurs during acute reduction in serum calcium levels in children and adults, as well as in experimental animals [3,4,16,18,19]. Chronic hypocalcemia has also been associated with myocardial dysfunction in numerous studies and case reports [1,2,7,8].…”

mentioning

confidence: 96%

Cardiac Functions in Children with Vitamin D Deficiency Rickets

1999

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“…[13] have described patients with severe hypocalcemia, marked cardiomegaly and EKG alterations who recovered with correction of calcium levels. T roughton and Singh [16] discuss the role of hypocalcemia in the congestive heart failure of the newborn. Only two patients in this series presented severe hypocalcemia, which was corrected.…”

Section: Discussionmentioning

confidence: 99%

Uremic Myocardiopathy

Ianhez

Lowen

Sabbaga³

1975

Nephron

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The authors report on the myocardiopathy of seven patients with end-stage renal disease, characterized by fever, in four patients; tachycardia, gallop rhythm, pericardial rub, in most of patients; signs and symptoms of cardiac failure and increased cardiac area and alterations of the EKG in all patients. Good remission of the symptoms was achieved in two patients by hemodialysis and by successful renal transplantation in the others. The likely etiologic factors of the syndrome are discussed.

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“…Discussion / > X .We believe that we excluded the common causes .......for heart failure in this infant and her recovery was -' so rapid and complete that we find it difficult to believe that it was due to viral myocarditis. It seems / -ilikely that fluid overload was the basic cause but the -hypocalcaemia, itself probably due to the excessive intake of cows' milk, may have contributed (Troughton and Singh, 1972). Even allowing for the / -~~~~~~dilution of the milk used, the much higher concentration of sodium in cows' milk compared with breast milk and the huge amounts given could well have exceeded the renal capacity for excretion.…”

Section: Case Reportmentioning

confidence: 99%