Key result
Rising PTH and worsening MAC linked to complete AV block requiring pacing in hemodialysis.
Case Report (n=1)
In patients with ESRD, elevated parathyroid hormone levels may drive metastatic cardiac calcification leading to progressive AV block, highlighting the importance of monitoring and optimizing calcium, phosphorus, and PTH levels.
May prompt evaluation for metastatic calcification in ESRD with high PTH and AV block; leaves open whether PTH normalization prevents progression.
The appearance of first-degree atrioventricular block and mitral annulus calcification in an end-stage renal failure patient with elevated parathyroid hormone levels should raise the suspicion of metastatic cardiac calcification. Measures should be taken to normalize the parathyroid hormone, calcium, and phosphorus levels to limit the progression of atrioventricular block. Exploration or removal of parathyroid glands should be considered if heart block worsens.
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Anam et al. (2021) conducted a case report in Complete Atrioventricular Block Secondary to Tertiary Hyperparathyroidism (n=1). Tertiary hyperparathyroidism and mitral annular calcification was evaluated on Development of complete atrioventricular block. Progressively increasing parathyroid hormone levels and worsening mitral annular calcification in a hemodialysis patient led to the development of complete atrioventricular block requiring a pacemaker.
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