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Introduction Thyroid disease is an independent predictor of heart failure in patients. This study aimed to investigate the prevalence of thyroid dysfunction among patients with heart failure in Mogadishu, Somalia. Methods From January 2019 to January 2021, a total of 250 patients diagnosed with heart failure admitted to the cardiology outpatient and emergency departments were evaluated retrospectively. The demographic characteristics, the cause of heart failure, and the kind of heart failure were recorded. Patients were categorized into subclinical hypothyroidism, hypothyroidism, low T3 syndrome, subclinical hyperthyroidism, and hyperthyroidism. Results A total of 250 heart failure patients. The prevalence of thyroid dysfunction among heart failure patients was 35.6%. The mean age of the patients was 59.8±14 years. Males outnumbered females by 159 (63.2%). The prevalence of thyroid dysfunction was 35.6%. Out of the 250 patients that were examined, most of the patients 30(33.3%) had subclinical hypothyroidism. 23 (25.6%) had overt hypothyroidism, 15 (16.7%) had overt hyperthyroidism, 20 (22.2%) had low T3 syndrome, and two cases had subclinical hyperthyroidism. Regarding the gender status of the thyroid dysfunction, 43(48.3%) were male, and 46(51.7%) were female. Regarding heart failure types among thyroid dysfunction patients, most patients were HFrEF (n=64, 71.9%), and 25(28.1%) were HFpEF. Patients with heart failure and reduced ejection fraction (HFrEF) were more likely to have thyroid dysfunction than those with preserved ejection fraction (p = 0.012). Regarding comorbidities among heart failure patients with thyroid dysfunction, approximately half of the patients had hypertension (40.4%). Conclusion Thyroid problems are one of the most prevalent endocrine abnormalities in our practice. Subclinical hypothyroidism was the most common type of thyroid dysfunction among this population. We suggest that thyroid function be evaluated with cardiac function in patients with heart failure and followed up and treated together with heart failure.

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Endocarditis is a life-threatening infection of the endocardium (inner lining of the heart). It usually affects the left-sided valves more than the right-sided valves and presents classically with a new murmur, fever, and peripheral stigmata. Though in the modern era, we have better antibiotics, better diagnostic imaging, and surgery that might cure infectious endocarditis (IE), it still carries significant mortality and morbidity. Here we present a 52-year-old male patient with hypertension and ischemic heart disease who presented with shivering, fever, and confusion for 2 days, fourteen days after cardiac intervention (PCI). Further trans-esophageal echocardiography was done due to the patient’s fulfillment of three minor and one major of Duke's criteria. Trans-esophageal echocardiography revealed flailing posterior mitral valve leaflets, 1.1 x 0.60 cm of vegetation, and severe eccentric mitral regurgitation. The patient was managed with vancomycin and gentamicin and referred to the cardiovascular surgery center. Post-PCI infective endocarditis is a rare and often missed diagnosis, so there should be a high level of suspension for those who present with signs and symptoms compatible with infective endocarditis.

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