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A Case of Severe Dilated Cardiomyopathy and Hyperthyroidism
Mohammad Haidous1, Abdul Rahman Al Armashi1, Patil Balozian1
1Internal Medicine, St. Vincent Charity Medical Center, Cleveland, USA.
Cureus
|April 13, 2022
Summary
Untreated hyperthyroidism can cause heart failure. This case shows a patient with hyperthyroidism, severe systolic dysfunction, and dilated cardiomyopathy, emphasizing the need for thyroid assessment in heart failure evaluation.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Hyperthyroidism is a known risk factor for developing heart failure, particularly high-output heart failure and left ventricular (LV) hypertrophy.
- While severe LV dysfunction is uncommon, it can occur in a small subset of hyperthyroid patients.
Observation:
- A 65-year-old male with hypertension presented with acute heart failure symptoms including dyspnea and edema.
- Physical examination revealed tachycardia; however, classic signs of hyperthyroidism like exophthalmos or thyromegaly were absent.
- Laboratory results confirmed hyperthyroidism (suppressed TSH, elevated FT3 and FT4) and elevated B-natriuretic peptide, indicative of heart failure.
Findings:
- Electrocardiogram showed sinus tachycardia and an incomplete left bundle branch block.
- Echocardiography revealed moderate to severe LV dilatation, severe LV systolic dysfunction (EF 30-35%), and abnormal diastolic function, without LV hypertrophy.
- The patient was diagnosed with hyperthyroidism-induced dilated cardiomyopathy and acute heart failure.
Implications:
- This case underscores the critical importance of thyroid function assessment in patients presenting with heart failure symptoms.
- Prompt management of hyperthyroidism is essential for improving cardiac function and managing heart failure.
- Clinicians must balance treating hyperthyroidism symptoms with addressing acute heart failure in affected patients.
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