Severe Dilated Cardiomyopathy as the First Manifestation of Hypothyroidism: Case Report
A detailed clinical case of hypothyroidism-induced, reversible dilated cardiomyopathy is presented.
A 31-year-old man was admitted with severely decompensated heart failure. At initial assessment, his condition was categorized as New York Heart Association (NYHA) functional class IV and the transthoracic echocardiography estimated 22% left ventricular ejection fraction. Blood tests revealed undetectable thyroid hormone levels as well as elevation of thyroid stimulating hormone, supporting the diagnosis of hypothyroidism. Both anti-thyroglobulin and anti-microsomial antibodies were positive. After one year treatment with L-thyroxin, clinical condition improved to a NYHA class I and transthoracic echocardiography showed left ventricular ejection fraction improvement up to 47%.
The case report presents an unequivocal diagnosis of dilated cardiomyopathy secondary to hypothyroidism. Although rarely a cause of that cardiac disorder, thyroid function should systematically be accessed in all patients with a so far unclear etiology.
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