1. Cardiomyopathy Associated with Trace-Element Deficiency
Post Bariatric-Surgery
Malka Yahalom1 ,Ehud Rozner1 ,Yoav Turgeman12
1Heart Institute, HaEmek Medical Center
2Rappaport Faculty of Medicine, Technion, Haifa

2. Introduction
Non-Compliance with vitamins and Mineral supplement protocol after Bariatric-Surgery may lead to true-element deficiency (such as Zinc, Iron, Vitamin B and Selenium).
It has been proved that its deficiencies result in Myocardial Fibrosis, CHF, Arrhythmias and Death. A phenomenon that resembles Keshan Disease in China (congestive cardiomyopathy due to selenium deficiency).

3. Case - Report
A 30 year old female, 1½ months after delivery, was admitted to cardiology department because of Dyspnea, and clinical evidence of Heart Failure. Her past history indicated Morbid obesity, Bariatric surgery fifteen and five years earlier. Anemia. B12 and Zinc deficiency.
The Selenium level could not be measured in our available laboratories.

4. On examination there were signs of left and right heart failure as Tachycardia, S3, Jugular veins congestion, Pulmonary Edema and severe Pitting Edema.
An Echocardiogram revealed severely reduced function (LVEF=30%).

5. The diagnosis was Cardiomyopathy (Peripartum on top of True-Element Deficiency). The patient was treated with anti-failure therapy (diuretics, vasodilators agents combined with dietary supplements).
A 10 kilogram weight reduction was observed.

6. Conclusions
Patients after Bariatric surgery should be follow up by a combined craniological and nutritional team, in order to prevent Cardiac deterioration, CHF and Death.