Acute Heart Failure in Hypothyroidism: A Rare Clinical Presentation and Management Case Study

Dr. Arulanandhan Ettiyan, Dr. Kannan Radhakrishnan, Dr. Raghothaman Sethumadhavan, Dr. Sureshkumar Ponnuswamy

Abstract: A 45-year-old female presented with syncope and symptoms suggestive of hypothyroidism. Despite severe hypothyroidism, she lacked classic signs of myxedema or coma. Cardiac assessment revealed severe left ventricular systolic dysfunction (LVSD) with normal coronary arteries. Treatment with low-dose levothyroxine and heart failure therapy led to significant improvement in symptoms and cardiac function within a month. This case highlights the importance of early recognition and management of hypothyroidism-induced heart failure, emphasizing its reversible nature with timely thyroid replacement therapy. Clinical examination revealed anemia and pedal edema. Her BP was 100 / 70 & PR ? 66/min SPO2 ? 94% at RA. ECG Showed sinus rhythm, Low voltage, no evidence of ischemia. TSH levels were 225 mIU/L, and free T3 levels were <0.02 ng/dL. Thyroglobulin & thyroid microsomal antibodies were positive. Laboratory investigations showed mild Anemia, normal renal function and electrolytes. NT pro BNP & D-dimer elevated. Mental status intact & showed no features of myxedema or coma. Echo showed Severe LV SD ? 34%. Mild PHT. CAG - Normal Epicardial Coronaries, started on Low dose Levothyroxine & Guideline directed medical therapy for heart failure. After One month follow up her symptoms improved. She had lost around 5 Kg weight. NT Pro BNP & D-dimer became Normal. Ejection Fraction improved.

Keywords: hypothyroidism, acute heart failure, left ventricular dysfunction, thyroid replacement therapy, cardiovascular effects

How to Cite?: Dr. Arulanandhan Ettiyan, Dr. Kannan Radhakrishnan, Dr. Raghothaman Sethumadhavan, Dr. Sureshkumar Ponnuswamy, "Acute Heart Failure in Hypothyroidism: A Rare Clinical Presentation and Management Case Study", Volume 13 Issue 12, December 2024, International Journal of Science and Research (IJSR), Pages: 424-425, https://www.ijsr.net/getabstract.php?paperid=SR241204180641, DOI: https://dx.doi.org/10.21275/SR241204180641