Title: Clinical Profile of Hypothyroidism with Special Reference to Cardiovascular Complications
Authors: Dinesh Sisodiya, Shishir Pandey, Anurag Chaurasia, Rakesh Patel
DOI: http://dx.doi.org/10.18535/jmscr/v4i9.89
Hypothyroidism is a clinical syndrome resulting from deficiency of thyroid hormones in the target tissues. . Primary hypothyroidism is common worldwide especially in iodine deficient areas like India. In non-endemic areas chronic autoimmune thyroidectomy and destructive treatment of thyrotoxicosis are common. . The yearly incidence of spontaneous hypothyroidism per 1000 was estimated to be 3.5 and 0.6 in females and in males respectively1. The cardiovascular abnormalities associated with thyroid dysfunction, remain barely unattended which ultimately lead to heart failure and death. Here we have made a modest attempt to define the clinical spectrum of hypothyroidism with special reference to cardiovascular manifestation Aims and Objectives: 1. To study correlation of symptomatology with serum thyroid hormone levels. 2. To study the cardiovascular changes associated in hypothyroidism. 3. To study co-morbid condition associated with hypothyroidism Methods and Material: This study was conducted on 100 patients admitted in S.G.M.H. REWA, >12 years of age showing signs and symptoms of hypothyroidism or known case of hypothyroidism and detailed history, physical examination, thyroid profile, ECG, 2D-echocardiography were done. Result: The most common ECG feature was nonspecific ST-T wave changes in 77.61% Low voltage complexes were seen in 37.31%, prevalence of low voltage complexes was higher in the group with TSH levels >10 mili IU/l, pericardial effusion was present in 37.5% and left ventricular hypertrophy in 23.43%. the prevalence of pericardial effusion was higher in the group with TSH levels >10 mili IU/l,the clinical parameters were more abnormal in the group with TSH levels >10 mili IU/l Conclusion: Hypothyroidism is a multitude of clinical presentations involving various systems in the body. cardiovascular disease are very common among these patients physicians should suspect hypothyroidism from the subtle signs and symptoms of the disease so that an early diagnosis and timely treatment is initiated. 1. Vanderpump MPJ, Turn bridge WMG, et al: The incidence of thyroid disorders in the community: a twenty-year follow-up of the whickham Survey. Clinical Endocrinology (Oxf) 1995; 43:55-68 2. Roos A, Zoet Nugteren SK et al. Evaluation of cardiac ischemia in cardiac asymptomatic newly diagnosed untreated patients with primary hypothyroidism. The journal of medicine Netherlands. 2005; 61: 97-102. 3. Kerber RB, Sherman B. Echocardio-graphic evaluation of pericardial effusion in myxoedema: Incidence and Biochemical and clinical correlation. Circulation. 1975; 52(5) : 823-827 4. Rajan SK, Srinivasan R, Mohan J. Evaluation of the heart in hypo patients. An echocardiographic study. Indian Practitioner. 2003; 56(12): 815-818. 5. Vora J, O'Malley B.P., Peterson S et al. Reversible abnormalities of myocardial relaxation in hypothyroidism. JCEM. 1985; 61 (2): 269-272. 6. Mohandas MS, Goldmar JM. Hypothyroid cardiomyopathy: echocardiographic documenttation of reversibility. Am J of med Sci. 1985; 61:(2): 629-272. 7. Zulewski H, Millar B, Exer P, et al. Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. J Clin Endocrinol Metab 1997; 82:771-776.Abstract
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