Aim: To study the cardiac manifestations of hypocalcemia in infants and note the effect of treatment.

Method: 30 infants (1 month to 1 year) with hypocalcemia diagnosed by biochemistry along with 15 age and sex-matched healthy controls were included. Clinical manifestations, X ray chest, ECG and Echocardiographic data were assessed.

Results: The presenting symptoms were convulsions in 23 infants, failure to thrive in 11, respiratory distress in 3 (of which 2 had congestive heart failure) and no symptoms in 2. Cardiothoracic ratio was abnormal in 8 and 11 had ECG abnormalities (Sinus tachycardia in 2, prolonged PR interval in 2, abnormal QRS axis for age in 2 and T- wave abnormalities in 4). The Echocardiographic/ Color doppler evaluation revealed abnormal findings in 13/30 patients (p value < 0.05). Mild to moderate tricuspid regurgitation in 4 , hypercontractile heart in 7, left ventricular dilatation in 3 and LV dysfunction in 2 .The 2 patients with LV dysfunction needed IV calcium infusion along with other inotropes and showed marked improvement in ejection fraction and fractional shortening on therapy. The other patients were treated with intravenous or oral calcium and Vitamin D supplementation. Normalization of cardiac status was noted after one month in all with said abnormalities.

Conclusion: Cardiac manifestations are sub-clinical in hypocalcemic infants. X- ray & ECG changes may be seen but 2 D- Echocardiographic and colour Doppler evaluation is necessary to note the cardiac status (especially Left ventricular function). Hypocalcemia must be ruled out in all infants with cardiomyopathy.