During 1981 - 1986 3 women with similar complaints were seen. Their symptoms were tetany and congestive cardiac failure (CCF) without a previous history of cardiac disease or alcohol abuse. One patient did have a history of cataract removal and epilepsy and all 3 had ECGs showing prolonged Q-T intervals and echocardiograms consistent with the diagnosis of cardiomyopathy. Biochemical profiles were similar: hypocalcaemia, hyperphosphataemia and normal serum urea levels. Parathyroid hormone levels were inappropriately low in all 3 cases. The tetany and CCF responded to calcium +/- magnesium infusions together with diuretics and in 2 cases, digoxin therapy. All 3 patients are well at present, and are controlled on 1-alpha-hydroxyvitamin D3 and calcium supplements.