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

M Okada¹, T Ota, H Okura

¹Division of Cardiology, Fuchu Hospital, Hiko-cho 1-10-17, Izumi, Osaka 594-0076.

Journal of Cardiology

|June 8, 2001

Summary

Graves' disease can cause reversible pulmonary hypertension. Thyroidectomy improved cardiac output and pulmonary hypertension, but not pulmonary vascular resistance, suggesting complex underlying mechanisms.

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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.