Abstract
Hyperthyroidism is a common metabolic disorder with many cardiovascular manifestations. In rare cases, untreated hyperthyroidism can lead to thyrotoxic cardiomyopathy with severe left ventricular (LV) dysfunction. This case report aims to discuss the pathogenesis of heart failure in hyperthyroidism and the available treatment options.A 51-year-old male with a past history of untreated hyperthyroidism presented to our hospital for the evaluation of shortness of breath and dysphagia. Workup revealed atrial flutter and severe biventricular dilated cardiomyopathy. Stabilization thyroidectomy was performed due to dysphagia, and treatment with oral antithyroid medications was initiated. The patient was discharged on synthroid and beta-blockers.Untreated hyperthyroidism can lead to biventricular failure even in the young. Untreated hyperthyroidism leads to significant mortality and morbidity. Untreated hyperthyroidism is associated with atrial fibrillation, heart failure, pulmonary hypertension (PH), and angina-like symptoms. Further studies should be done to evaluate the pathogenesis of Graves/Goiter hyperthyroidism and the least-invasive, safe, and definitive treatment options should be discovered. Current treatment options are limited and include medication that needs to be taken lifelong; they are associated with toxicity. Radioactive iodine ablation comes with the drawback of long-term replacement therapy. The last option is surgery, which is invasive and has its own complications.
Highlights
Hyperthyroidism is a common metabolic disorder with cardiovascular manifestations
A 51-year-old male with a past history of untreated hyperthyroidism presented to our hospital for the evaluation of shortness of breath and dysphagia
This patient presented with severe but reversible systolic left ventricular (LV) dysfunction due to hyperthyroidism. He was relatively young, which indicates that the development of overt congestive heart failure (CHF) due to hyperthyroidism is not limited to the elderly population, but can develop in younger patients if hyperthyroidism is left untreated for a long period of time
Summary
Hyperthyroidism is a common metabolic disorder with cardiovascular manifestations It often causes classical high-output heart diseases because of decreased systemic vascular resistance and increased resting heart rate, left ventricular (LV) contractility, blood volume, and cardiac output [1,2]. A 51-year-old male with a past medical history of hypertension and hyperthyroidism presented to the emergency department with symptoms of cough, shortness of breath, palpitation, dysphagia, pedal edema, and subjective fever. The pathology showed multinodular goiter and the patient had an uneventful rest in the hospital. He was discharged on a beta-blocker, synthroid, lasix, and rivaroxaban
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