AN UNUSUAL CASE OF PATIENT WITH DILATED CARDIOMYOPATHY SECONDARY TO HYPOTHYROIDISM: A CASE REPORT

Abstract


 Background:Alteration in thyroid hormone may affect on the cardiovascular system because the heart is very sensitive to an alteration of thyroid hormone. Alteration in thyroid hormone has been known to cause the changes in cardiac structure and function, such as thedevelopment of dilated cardiomyopathy which is a very rare manifestation of hypothyroidism.
 Case Illustration:A 26-year-old woman came to a cardiology clinic with a chief complaint of fatigue and breathlesness. On physical examination are unremarkable. On clinical laboratory examinations showed elevated TSH serum levels and decreased FT4 serum levels. On echocardiography, the patient had moderate mitral regurgitation, mild tricuspid regurgitation, all chamber dilatation, and abnormal left ventricular systolic function with ejection fraction 26.9%. The treatment of this patient are levothyroxine 50ug/day, furosemide 40 mg, spironolactone 25 mg, bisoprolol 2.5 mg, ramipril 1.25 mg, and acetylsalicylic acid 80 mg all in once daily.
 Discussion:Dilated cardiomyopathy is characterized by enlargement of the ventricular chamber with impaired systolic function. Hypothyroidism is associated with decreased cardiac contractility and decreased cardiac output because of the genomic effect of thyroid hormone to the cardiovascular system is involved in the regulation of mRNA transcription of genes associated with the contractile system.
 Conclusions:Hyperthyroidism is often cause dilated cardiomyopathy, but in this case, hypothyroidism also can cause dilated cardiomyopathy. Early diagnosis and management of hypothyroidism are very important to restore the cardiac function.