Hypocalcemic cardiomyopathy due to primary or secondary hypoparathyroidism is usually refractory to conventional treatment for cardiac failure but responds favorably to the restoration of normocalcemia. We report on a thalassemic patient with severe cardiac failure due to hypocalcemia. Cardiac echocardiography showed impaired biventricular performance and laboratory analyses revealed hypoparathyroidism due to hemosiderosis. Concomitant treatment for heart failure and calcium supplementation was initiated. Thereafter, clinical and laboratory improvement was achieved. In the literature of thalassemic disorders, this is the first case of heart failure associated with hypoparathyroidism in which the patient recovered significantly after the correction of hypocalcemia, providing strong evidence to support our hypothesis of hypocalcemic myocardiopathy.
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