Hypocalcaemic Cardiomyopathy After Parathyroidectomy in a Patient With Turner Syndrome: A Case Report

Abstract

Hypocalcaemic cardiomyopathy is a rare postoperative complication after hemi-parathyroidectomy which reverses completely on the restoration of normocalcaemia. Patients of Turner syndrome have subtle cardiovascular anomalies due to the underlying oestrogen deciency. A 16-year-old female patient with Turner syndrome underwent hemi-parathyroidectomy for parathyroid adenoma. The patient developed signs of heart failure on postoperative day two, which was precipitated by tachycardia due to fever. She developed tachycardia, tachypnoea, hypertension, and pulmonary oedema with an ejection fraction of 20-30% at the time without any underlying cardiac disease. The patient was managed with intravenous diuretics, beta-blockers, and non-invasive ventilation. Other probable causes such as sepsis, pheochromocytoma, thyrotoxicosis, and Takotsubo syndrome were ruled out. A differential diagnosis of hypocalcaemic cardiomyopathy was suspected, and the patient was given intravenous calcium and vitamin-D supplementation. The patient responded promptly to restoration of normocalcaemia, and the cardiomyopathy reversed completely. Echocardiography done on follow-up showed normal ejection fraction.