Hypothyroidism Presenting as Dilated Cardiomyopathy

Generalized pitting edema in a patient with dilated cardiomyopathy secondary to hypothyroidism

“…4,5 Thus, epidemiological information is limited. 3,5,6 The exact mechanism of the development of dilated cardiomyopathy in patients with hypothyroidism remains unclear. Thyroid hormones are known to mediate genomic and nongenomic effects on the heart, and recent studies have shown changes in gene expression associated with biosynthesis or diminished bioavailability of thyroid hormones at the tissue level among patients with dilated cardiomyopathy.…”

“…7 Cardiac dysfunction among patients with dilated cardiomypathy secondary to hypothyroidism can be reversed with thyroid hormone replacement therapy. 3,6 Although hypothyroidism alone is an uncommon cause of dilated cardiomyopathy, clinicians should perform thyroid function tests in patients with un explained dilated cardiomyopathy. 4 Adverse cardiovascular events may result from quick thyroid hormone replacement, without tapered escalation, especially among older patients, those with underlying ischemic heart disease or cardiac dysfunction, or those with severe and longstanding hypothyroidism.…”

Œdème à godet généralisé chez un patient présentant une myocardiopathie dilatée secondaire à une hypothyroïdie

“…Outre l'action connue des hormones thyroïdiennes sur le coeur, passant par des effets génomiques et non génomiques, des études récentes ont permis de constater des variations de l'expression génique associées à la biosynthèse ou à la diminution de la biodisponibilité de ces hormones dans les tissus de la patientèle atteinte de myocardiopathie dilatée 7 . La dysfonction cardiaque de la patientèle atteinte de myocardiopathie dilatée secondaire à une hypothyroïdie peut être réversible avec une hormonothérapie thyroïdienne substitutive 3,6 . Il est rare que l'hypothyroïdie suffise à provoquer une myocardiopathie dilatée, mais les médecins devraient tester la fonction thyroïdienne en cas de myocardiopathie dilatée inexpliquée 4 .…”

Endocrine cardiomyopathy: A review and pooled analysis of pathophysiology, diagnosis and clinical management

“…TH that exerts a direct cellular effect on almost all tissues of the body. The heart is very sensitive to TH changes and the most prominent and common symptoms of thyroid dysfunction are those that result from the effects of TH on the heart and cardiovascular (CVD) system [9][10][11][12][13][14][15][16]. Hyperthyroidism and hypothyroidism produce significant changes in cardiac contractility, cardiac output, myocardial oxygen consumption, blood pressure and systemic vascular resistance [17][18][19][20][21].…”