Abdelwahab TH Elidrissy
University of Science and Technology Khartoum, Sudan
Title: Hypocalcemic Rachitic Cardiomyopathy in Infants
Biography
Biography: Abdelwahab TH Elidrissy
Abstract
Hypocalcemic cardiomyopathy in infants is characterized by heart failure in a previously normal infant with hypocalcemia without organic cardiac lesion. Vitamin D deficiency rickets is increasing in Middle East. In a six month study 136 cases of rickets were diagnosed in the main Children's Hospital in Almadinah but none of them showed evidence of cardiomyopathy except a case presented in this meeting. Concerned of missing this serious complication of rickets we searched pub med and present this review article.
61 cases of hypocalcemic cardiomyopathy were reported as case reports with two series of 16 and 15 cases from London and Delhi, respectively. The major features of these cases: the age ranged from one month to 15 months with a mean age of 5 months. All presented with heart failure and hypocalcemia. There was a minor feature of rickets in a few of the cases. All had high alkaline phosphatase. Echo cardiology evidence of cardiomyopathy was found in all. Most of them responded to calcium, vitamin D and cardio tonic and diuretics.
We concentrated on pathogenesis of this hypocalcemic cardiomyopathy and reviewed the literature. The evidence available supports that the most likely cause of cardiomyopathy is hypocalcemia. Hypo vitamin D also contributes but hyperparathyroidism might have a protective role as we did not detect any evidence of cardiomyopathy with hyperparathyroidism per sey and florid features of rickets.
We need to look out for cardiomyopathy among infants with hypocalcemia. For prevention maternal supplementation during pregnancy and lactation with up to 2000 units of vitamin D and 400 units for their infants.