Huang Rui, Yan Li, Lei Yuhua, Li Yuanhong
Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi Prefecture, 445000, Hubei Province, People's Republic of China.
Pediatrics Department, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi Prefecture, 445000, Hubei Province, People's Republic of China.
Int Med Case Rep J. 2021 Mar 19;14:171-176. doi: 10.2147/IMCRJ.S296071. eCollection 2021.
Thyroxine is closely related to cardiovascular diseases, such as coronary heart disease, ventricular arrhythmia, atrioventricular block, myocardial systolic weakness, pericardial effusion, low cardiac output and hypertension. Previous studies have also found that hypothyroidism can also lead to mental disorders. Here, we present a rare case of severe hypothyroidism patient accompanied by sick sinus syndrome (SSS) as a cardiovascular manifestation needing cardiac pacing and severe mental disorders.
A 42-year-old female patient, previously healthy, was referred to our hospital because of bradycardia complicated with sick sinus syndrome which requiring cardiac pacing and severe mental disorders. Her clinical features along with laboratory findings strongly suggested that the patient had severe hypothyroidism with sick sinus syndrome and mental disorders, both of which were reversible and successfully treated with levothyroxine.
This is the first reported case of hypothyroidism with sick sinus syndrome requiring pacemakers and psychiatric disorders, and the symptoms can be improved and reversed after thyroxine supplementation. This case highlights the importance of hypothyroidism screening when faced with unexplained psychosis or sick sinus syndrome, especially if combined.
甲状腺素与心血管疾病密切相关,如冠心病、室性心律失常、房室传导阻滞、心肌收缩无力、心包积液、低心输出量和高血压。既往研究还发现,甲状腺功能减退也可导致精神障碍。在此,我们报告一例罕见的严重甲状腺功能减退患者,伴有病窦综合征(SSS)作为需要心脏起搏的心血管表现以及严重精神障碍。
一名42岁女性患者,既往健康,因心动过缓合并病窦综合征,需要心脏起搏及严重精神障碍转诊至我院。她的临床特征及实验室检查结果强烈提示该患者患有严重甲状腺功能减退合并病窦综合征及精神障碍,两者均为可逆性,且通过左甲状腺素成功治疗。
这是首例报道的甲状腺功能减退合并病窦综合征需要起搏器治疗及精神障碍的病例,补充甲状腺素后症状可改善并逆转。该病例突出了面对不明原因的精神病或病窦综合征(尤其是两者合并时)进行甲状腺功能减退筛查的重要性。