Right ventricular dysfunction secondary to hyperthyroidism with total reversal after thyroidectomy: case report
Article Sidebar
Main Article Content
Abstract
Thyrotoxicosis is a condition caused by an increase in thyroid hormone, commonly associated with Graves' disease and toxic multinodular goiter. Hyperthyroidism is known to increase the risk of pulmonary hypertension and right heart failure, although the underlying mechanisms are still unclear. The identification of these conditions is crucial, as they are potentially reversible with the achievement of euthyroidism. This case report describes a 40-year-old woman with right ventricular dysfunction and pulmonary hypertension due to hyperthyroidism, which was successfully treated with total thyroidectomy. The case highlights the importance of considering thyrotoxicosis as a potential cause of pulmonary hypertension and the need to rule out other underlying causes. Echocardiography is a valuable tool in assessing right ventricular dysfunction, and achieving euthyroidism can result in the reversal of structural and functional cardiac alterations.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels M, Sosa JA, Stan MN, Walter MA. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thy-rotoxicosis. Thyroid. 2016;26(10).
Rashidi F, Sate H, Faraji E, Tahsini Tekantapeh S. Thyrotoxicosis presenting as exertional dyspnea and pulmonary hyper-tension: Case report and review of literature. SAGE Open Med Case Rep. 2017;5.
Singarayar CS, Siew Hui F, Cheong N, Swee En G. Right ventricular dysfunction and pulmonary hypertension: a neglected presentation of thyrotoxicosis. Endocrinol Diabetes Metab Case Rep. 2018;2018.
Khan Z, Mlawa G, Bashir M, Abumedian M, Yousif S, Gupta A, Warrier V. Resolution of Thyrotoxicosis-Associated Pulmonary Hypertension With Treatment of Thyrotoxicosis: A Case-Based Report and Literature Review. Cureus. 2022;
de Freitas Ribeiro RN, de Freitas Ribeiro BN. Hipertensäo pulmonar em um paciente com hipertireoidismo. Insuficiencia Cardiaca. 2011;6(1).
Ata F, Khan AA, Yousaf Z, Choudry H, Mohammed AM, Ahmed B, Umer AM, Khan F, Al Mohanadi DHS, Naem E, Zahid M. The clinical characteristics and outcomes of patients with pulmonary hypertension in association with hyperthyroid state: A systematic review. Medicine. 2022 Jul 1;101(26):e29832.
Chacko SR, Ram P, Fox T, Sooknanan N, Lo KB, Menezes RG, Lasrado S, Eiger G, Vaidya A. Impact of achieving euthyroidism on pulmonary artery systolic pressures in hyperthyroidism-associated pulmonary hypertension - a systematic review. Am J Cardiovasc Dis. 2022;12(4):212–23.
Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Rådegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S, Schwerzmann M, Dinh-Xuan AT, Bush A, Abdelhamid M, Aboyans V, Arbustini E, Asteggiano R, Barberà JA, Beghetti M, Čelutkienė J, Cikes M, Condliffe R, de Man F, Falk V, Fauchier L, Gaine S, Galié N, Gin-Sing W, Granton J, Grünig E, Hassoun PM, Hellemons M, Jaarsma T, Kjellström B, Klok FA, Konradi A, Koskinas KC, Kotecha D, Lang I, Lewis BS, Linhart A, Lip GYH, Løchen ML, Mathioudakis AG, Mindham R, Moledina S, Naeije R, Nielsen JC, Olschewski H, Opitz I, Petersen SE, Prescott E, Rakisheva A, Reis A, Ristić AD, Roche N, Rodrigues R, Selton-Suty C, Souza R, Swift AJ, Touyz RM, Ulrich S, Wilkins MR, Wort SJ, Krim M, Hayrapetyan H, Musayev O, Lazareva I, Sokolović Š, Velchev V, Michaloliakos I, Jansa P, Mellemkjær S, Hassan A, Anton L, Pentikäinen M, Meneveau N, Tsverava M, Lankeit M, Manginas A, Hizoh I, Maher V, Hirsch R, Mukarov MA, Ibrahimi P, Talant S, Rudzitis A, Kiwan G, Gumbienė L, Codreanu A, Micallef J, Vataman E, Bulatovic N, Chraibi S, Post MC, Kostovska ES, Andreassen AK, Kurzyna M, Plácido R, Coman IM, Vasiltseva O, Zavatta M, Šimkova I, Poglajen G, Lázaro Salvador M, Söderberg S, Marjeh MYB, Ouarda F, Mutlu B, Sirenko Y, Coghlan JG, Abdullaev T, Baigent C, Antoniou S, Arbelo E, Baumbach A, Borger MA, Collet JP, Gale CP, Halvorsen S, Iung B, Landmesser U, Sitges M, Morgan RL, Sivakumaran K. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Vol. 43, European Heart Journal. 2022.
Davies TF, Andersen S, Latif R, Nagayama Y, Barbesino G, Brito M, Eckstein AK, Stagnaro-Green A, Kahaly GJ. Graves’ disease. Vol. 6, Nature Reviews Disease Primers. 2020.