| CASE REPORT |
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| Year : 2021 | Volume
: 11
| Issue : 4 | Page : 201-204 |
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Simultaneous presence of atrial arrhythmia and hypocalcemia in dilated cardiomyopathy: A series of two cases
Anil Kumar Singhi1, Sanjeev S Mukherjee2, KH Shine Kumar3, Raman Krishna Kumar3
1 Department of Pediatric Cardiology, Medica Super Specialty Hospital, Kolkata, West Bengal, India
2 Department of Cardiology, Medica Super Specialty Hospital, Kolkata, West Bengal, India
3 Department of Paediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
Correspondence Address:
Dr. Anil Kumar Singhi
Senior Consultant, Department of Pediatric Cardiology, Medica Super Specialty Hospital, Mukundapur, Kolkata - 700 099, West Bengal
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JICC.JICC_70_20
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Dilated cardiomyopathy in young children has varied etiological factors. Some cases have correctable causes such as incessant arrhythmia, correctable metabolic abnormality, and left ventricular obstructive lesions. Two 4-month-old infants presented with severe left ventricular dysfunction and ectopic atrial tachycardia. Biochemical profile of the infants showed low ionic and total calcium, elevated serum phosphate, elevated alkaline phosphatase, and elevated serum lactate. The parathyroid hormone was elevated and 25-hydroxyvitamin D3 was reduced. The patients were treated with beta-blocker, calcium, and Vitamin D supplementation, along with antifailure therapy. The tachycardia resolved over a 12-h period and calcium normalized in the next few days. The left ventricular function returned to normal over a 5–16-month period. In 6–8 years of follow-up, patients were in sinus rhythm doing very well with normal cardiac function with normal calcium-related biochemical parameters. The presence of incessant atrial arrhythmia in a case of hypocalcemic cardiomyopathy is rare and can have link with hypocalcemia-induced electrical changes in the cardiomyocyte in selected cases. Thorough and protocol-based treatment approach helps in correct diagnosis and treatment. Further study and molecular research can shed more light on the complex interaction of hypocalcemia and arrhythmia.
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