由甲状腺功能亢进引起的有症状和严重的肺动脉高压。
Symptomatic and severe pulmonary hypertension due to hyperthyroidism.
机构信息
Department of Cardiology, Nagano Municipal Hospital, Tomitake, Nagano, Japan
Department of Cardiology, Nagano Municipal Hospital, Tomitake, Nagano, Japan.
出版信息
BMJ Case Rep. 2022 Aug 3;15(8):e251120. doi: 10.1136/bcr-2022-251120.
Hyperthyroidism has been recognised as the cause of secondary pulmonary hypertension (PH). However, several studies have reported that most PH cases due to hyperthyroidism are asymptomatic and not severe. Here, we report the case of a woman in her 30s with symptomatic and severe PH due to hyperthyroidism. She presented with a 2-month history of dyspnoea on exertion, palpitation and lower-extremity oedema. Echocardiography showed severe PH with estimated pulmonary arterial systolic pressure (ePASP) of 62 mm Hg. The diagnostic work-up showed severe PH due to hyperthyroidism. After treatment for hyperthyroidism, improvement of thyroid function contributed to a decrease in ePASP to 30 mm Hg. Similar to the present case, PH due to hyperthyroidism generally improves with the treatment of hyperthyroidism. Therefore, we must not overlook hyperthyroidism as a cause of PH and diagnose and start treatment for PH-causing hyperthyroidism at an early stage.
甲状腺功能亢进症已被认为是继发性肺动脉高压（PH）的病因。然而，有几项研究报告称，大多数由甲状腺功能亢进症引起的 PH 病例是无症状且不严重的。在这里，我们报告了一例 30 多岁的女性因甲状腺功能亢进症而出现有症状和严重的 PH。她表现为呼吸困难、心悸和下肢水肿，病史为 2 个月。超声心动图显示严重的 PH，估计肺动脉收缩压（ePASP）为 62mmHg。诊断性检查显示甲状腺功能亢进症引起的严重 PH。甲状腺功能亢进症治疗后，甲状腺功能的改善导致 ePASP 下降至 30mmHg。与本病例类似，甲状腺功能亢进症引起的 PH 通常随甲状腺功能亢进症的治疗而改善。因此，我们绝不能忽视甲状腺功能亢进症是 PH 的一个病因，并且必须早期诊断和开始治疗导致 PH 的甲状腺功能亢进症。
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