Heart failure due to metabolic derangements is not common in clinical practice. However, outcome is usually positive given that the precipitating factor is recognized and treatment is initiated in a timely fashion. We report an unusual case of reduced left ventricular systolic function as a result of hypocalcemia and long standing untreated primary hypothyroidism in a patient without structural heart disease. Delay in seeking appropriate medical attention for both disorders has culminated in cardiac dysfunction that was favorably altered with correction of underlying etiologies. Therefore, early recognition and expedient management of hypocalcemia and hypothyroidism can result in an imminent improvement of cardiac function