Hypocalcemic cardiomyopathy due to hypoparathyroidism is a very rare condition. Ensuing heart failure due to hypocalcemia is refractory to conventional treatment. We reported a 41-year-old man who developed cardiac failure due to hypocalcemia secondary to idiopathic hypoparathyroidism. Echocardiography showed biventricular low ejection fraction, dilated heart chambers, pulmonary hypertension, and valvular regurgitations. Serum calcium and parathyroid hormone levels were low. After treatment of heart failure and calcium-vitamin D supplementation, signs and symptoms of heart failure improved rapidly. At 6 months, biventricular systolic and diastolic functions returned to normal. Serum calcium level should be monitored in every patient with cardiac failure and hypocalcemia should be considered in patients with refractory heart failure.
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