Schenck John B, Rizvi Ali A, Lin Tu
Department of Medicine, University of South Carolina School of Medicine, Two Medical Park, Suite 502, Columbia, SC 292203, USA.
Am J Med Sci. 2006 Mar;331(3):154-6. doi: 10.1097/00000441-200603000-00008.
Hypothyroidism can manifest with myriad cardiac abnormalities, often consisting of a combination of morphologic and functional changes. Low voltage, sinus bradycardia, and slowed conduction are usually found on electrocardiography. We describe a patient with severe hypothyroidism who presented with presyncope, prolongation of the QT interval, and polymorphic ventricular tachycardia (torsades de pointes). No other cause for the malignant ventricular ectopy was evident. With levothyroxine therapy, the QT interval normalized and the ventricular tachycardia was abolished. In addition to its commonly known cardiac effects, myxedema can predispose to the potentially life-threatening arrhythmia of torsades de pointes. Conversely, in patients presenting with QT interval prolongation and polymorphic ventricular tachycardia, hypothyroidism should be considered in the differential diagnosis.
甲状腺功能减退可表现为多种心脏异常，通常包括形态学和功能改变的组合。心电图通常显示低电压、窦性心动过缓和传导减慢。我们描述了一名患有严重甲状腺功能减退的患者，该患者出现了先兆晕厥、QT间期延长和多形性室性心动过速（尖端扭转型室速）。未发现其他导致恶性室性心律失常的明显原因。通过左甲状腺素治疗，QT间期恢复正常，室性心动过速消失。除了其常见的心脏影响外，黏液性水肿还可能易引发潜在危及生命的尖端扭转型室速心律失常。相反，对于出现QT间期延长和多形性室性心动过速的患者，鉴别诊断时应考虑甲状腺功能减退。
