[Pulmonary hypertension associated with refractory hyperthyroidism: a case report]

Area of Science:

• Cardiology
• Endocrinology

Background:

• Graves' disease, an autoimmune disorder, can lead to hyperthyroidism.
• Hyperthyroidism can cause significant cardiovascular complications, including pulmonary hypertension.

Observation:

• A 25-year-old woman with Graves' disease presented with goiter and echocardiographic findings of a hyperdynamic heart, right ventricular dilation, and tricuspid regurgitation.
• Right heart catheterization revealed high cardiac output and pulmonary hypertension with elevated pulmonary vascular resistance.

Findings:

• Subtotal thyroidectomy led to improvement in pulmonary hypertension and normalization of cardiac output.
• Pulmonary vascular resistance and total pulmonary resistance did not normalize post-surgery.
• Reversible pulmonary hypertension in hyperthyroidism may be linked to increased pulmonary blood flow and sustained pulmonary artery resistance, potentially involving pulmonary endothelial dysfunction.

Implications:

• Thyroidectomy can be an effective treatment for resolving pulmonary hypertension associated with Graves' disease.
• Persistent pulmonary vascular resistance suggests that long-term pulmonary vascular changes may occur despite successful thyroid treatment.
• Further research is needed to elucidate the mechanisms of pulmonary endothelial dysfunction in hyperthyroid-induced pulmonary hypertension.