Rastogi P, Dua A, Attri S, Sharma H
Department of Medicine, North DMC Medical College and Hindu Rao Hospital, New Delhi, India.
J Postgrad Med. 2018 Jul-Sep;64(3):177-179. doi: 10.4103/jpgm.JPGM_154_17.
Dilated cardiomyopathy (DCM) is an idiopathic condition that results from impaired ventricular systolic function. Thyroid diseases have been known to cause myriad changes in the structure and function of the heart. Diastolic dysfunction is a common abnormality reported in hypothyroidism. However, hypothyroidism-induced DCM and systolic dysfunction is an uncommon phenomenon, especially as the initial presenting manifestation of hypothyroidism. The current article describes the case of a young female who presented with symptoms of heart failure and was diagnosed as having DCM as echocardiography revealed left ventricular global hypokinesia and severely depressed systolic function. Thyroid profile revealed a grossly elevated thyroid-stimulating hormone (TSH) value of 313 μIU/ml; free thyroxine (fT4) was 0.220 ng/dl. The present case presented with DCM as the initial presentation of hypothyroidism and improved significantly after five months of levothyroxine replacement therapy.
扩张型心肌病（DCM）是一种由心室收缩功能受损导致的特发性疾病。甲状腺疾病已知会引起心脏结构和功能的多种变化。舒张功能障碍是甲状腺功能减退症中常见的异常表现。然而，甲状腺功能减退症诱发的DCM和收缩功能障碍是一种不常见的现象，尤其是作为甲状腺功能减退症的初始表现。本文描述了一名年轻女性的病例，该患者出现心力衰竭症状，经超声心动图显示左心室整体运动减弱和收缩功能严重降低，被诊断为患有DCM。甲状腺功能检查显示促甲状腺激素（TSH）值大幅升高，为313 μIU/ml；游离甲状腺素（fT4）为0.220 ng/dl。该病例以DCM作为甲状腺功能减退症的初始表现，在接受左甲状腺素替代治疗五个月后有显著改善。
