Hypothyroid Cardiomyopathy:

Abstract

Abstract;
A young lady with symptdms of partially treated postpartum pitutary failure over a period of three years and intermittent paroxysmal nocturnal dyspnoea and ankle swelling for six months preseñtedwith a worsening of he symptoms due toa pneumonic illness complicated by. disseminated intravascular coagulation. She was found to be . in biventricular failure and with treatment of her acute illness her cardiac status improved.• However, subsequent search for the cause of her dilated cardiomyopathy was unrevealing, but since she was overtly hypothyroid secondary to her postpartum failure it was reasonable to ascribe her cardiac status to Hypothyroidism, for which she received treatment and showed signs of improvement initially. A review of the literature on the subject is presented.

Introduction:
Dilated Cardiomyopathy in the young patient poses an aetiological diagnostic ‘challenge, since detection of a treatable lesion is always a priority. With tremendous improvement in the Cardiac imaging techniques, structural heart disease is less of a problem these days as compared to metabolic and biochemical factors leading to cardiac decompensation, the identification of these is vital for timely treatment, which may salvage myocardial function.
Abstract:
A young lady with symptdms of partially treated postpartum pitutary failure over a period of three years and intermittent paroxysmal nocturnal dyspnoea and ankle swelling for six months presented with a worsening of her symptoms due toa pneumonic illness complicated by. disseminated intravascular coagulation. She was found to be in biventricular failure and with treatment f her acute illness her cardiac status improved. However, subsequent search for the cause of her dilated cardiomyopathy was unrevealing, but since she was overtly hypothyroid secondary to her postpartum failure it was reasonable to ascribe her cardiac status to Hypothyroidism, for which she received treatment and showed signs of improvement initially. A review of the literature on the subject is presented.

Discussion:
The heart is a major target organ for thyroid hormone action and mãrkéd changes in cardiac function occur in patients with hyper or hypothyroidism. Cardiac contractility is increased in the hyperthyroid state and decreased in the hypothyroid state with changes in the specific proteins mediating cardiac contraction accoinpanying these alterations. Changes in thyroid status mediate their influence on cardiac function by a combination of direct thyroid hormone effects on the heart, alteration in the re spons i veñe ss of the cardiac sympatho-adrena 1 systemand hernodynamic effects generated in the periphery.’