[Hypothyroidism with pseudo-ischemic and hypertensive clinical presentation: physiopathological and diagnostic...

Serious primary hypothyroidism, disclosed fortuitously through routine thyroid function test derangements, was found in a 40-year-old woman admitted to the hospital with a tentative diagnosis of ischemic heart disease. The clinical picture and electrocardiographic alterations of pseudo-ischemic heart disease associated with hypertension, particularly diastolic, may be the only significant manifestations of hypothyroidism. Substitutive hormone replacement therapy enables a good prognosis for children and young adults. A diagnosis of hypothyroidism should be considered during the initial evaluation of pseudo-ischemic, hypertensive and hypercholesterolemic patients, even when no other signs or clinical symptoms of hormonal deficiency are evident. Particular attention should be paid to female patients, as they are much more frequently affected by thyroid pathologies.