Hypothyroidism as an Independent Risk Factor for Cardiac Diseases: A Cross-Sectional Study

Abstract

Background and Objectives: Hypothyroidism has significant cardiovascular manifestations. Inadequate number of studies and elusive nature of diagnosis of cardiovascular manifestations in hypothyroidism due to less prominence of symptoms and signs; attracted a great deal of investigatory endeavor. This study aims at studying the cardiovascular aftermath in hypothyroid patients by electrocardiography, lipid profile and echocardiography. The completely reversible nature of these complications, after starting treatment is well known. Methods: 150 Subjects under the study included, out-patient and in-patient hypothyroid cases coming to Sri Siddhartha Medical College and Hospital, Tumkur. Study duration – 1st September 2012 to 31 st August 2014. Patients were subjected to history, clinical examination and investigations like thyroid profile, electrocardiography, echocardiography and lipid profile. Data was analyzed using Epiinfo 7. Results; Out of 150 cases, 97 had clinical hypothyroidism, 53 had subclinical hypothyroidism. 88.67% cases were females. 54% were in age group 21-40 yrs. Abnormal ECG in 26%, abnormal ECHO in 24%, Diastolic hypertension in 20%, Dyslipidemia in 34.67%, pericardial effusion in 14%, Ischemic heart disease in 1.33% and Anemia in 23.33% were seen in the study. Conclusion: The hypothyroid patients present clinically with a myriad of symptoms and signs which are nonspecific. Hence a high index of suspicion is the key for the early diagnosis of hypothyroidism. The cardiac risk factors seen in the study are in the form of diastolic hypertension, bradycardia, dyslipidemia, T wave changes in ECG, diastolic dysfunction and pericardial effusion in ECHO. After exclusion of the other risk factors for cardiac disease; various changes seen in hypothyroid cases in this study suggest that hypothyroidism is one of the independent risk factor for cardiac disease. As the symptoms related to hypothyroidism and cardiac disease overlap, high index of suspicion should be considered for underlying cardiac disease; and these patients should undergo complete cardiac evaluation on diagnosis of hypothyroidism; so as to prevent the catastrophic cardiac outcomes. Early diagnosis and correction of hypothyroidism is necessary; so that adverse effects on cardiac system can be minimized. Studies have shown that with treatment of hypothyroidism the cardiovascular risk factors improve.