Title: ECG Changes in Thyroid Dysfunction in Diabetes Mellitus
Authors: Anoop Kumar, Rakesh Kumar, Darshan Mehra, Ankit Chaturvedi, Mahendra Sharma
Introduction: Thyroid disorder and DM are the two most common endocrine disorders encountered in clinical practice which have been shown to mutually influence each other and relationship between both the conditions had long been reported. A certain ECG changes have been recognized in thyroid disorder. this study conducted to see the relation of Thyroid gland with diabetes mellitus in already diagnosed diabetic patients.
Aim: To see the relation of Thyroid gland with diabetes mellitus in already diagnosed diabetic patients.
Material and Methods: A cross sectional study conducted in Rohilkhand Medical College and Hospital, Bareilly to see the relation of Thyroid gland with diabetes mellitus in already diagnosed diabetic patients. Total 130 Diabetes mellitus patients, 7 patients (5.4%) had T1DM and 123 patients (94.6%) had T2DM selected purposively for the study [Table 2].A patients were undergone to check the status of thyroid hormone, along with ECG. The data was collected and stastastically analyzed.
Results: Mean age of the all patients were 49.20 ± 13.2 years. The most common clinical signs are a narrowed pulse pressure, diastolic hypertension, low cardiac output, reduced EF impaired diastolic function and bradycardia. Overt hypothyroidism is associated with accelerated atherosclerosis and CAD due to hypercholesterolemia and diastolic hypertension. 34% of hypothyroidism showed significant ST‑T ECG changes with angina and CAD on subsequent investigation. Reduced EF and diastolic dysfunction were also significant in this study. In hyperthyroidism, sinus tachycardia, AF, wide pulse pressure, dyspnoea on exertion, exercise intolerance are common. Increased LV mass due to sustained volume overload with resultant cardiac work occurs in hyperthyroidism. This may cause ST‑T ECG changes due to LV strain. In this study, sinus tachycardia was the commonest ECG finding (61%), LV chamber hypertrophy was the second common abnormality (43%). ST‑T ECG changes are due to LV strain occurs in 21% of cases of hyperthyroidism.
Conclusions: Horizontal ST- segment depression of 1mm or more 0.08 s from the J- point with T- wave inversion was the ECG finding in 15 hypothyroidism; 3 in anterior LV wall leads, 4 in inferolateral LV wall leads. 10 hypothyroidism has sinus bradycardia in ECG , being the second commonest ECG abnormality. All hypothyroidism with ST- T changes had stable angina. The present study findings are in conformity with earlier studies. Sinus tachycardia was the commonest ECG finding in the hyperthyroidism 6(40%);LV hypertrophy 3 (20%); prolonged Q-Tc interval 2(13.3%); LV strain(ST-T changes), Atrial fibrillation, Atrial ectopics and Ventricular ectopics 1(6.7%).