Mire Waberi Mohamud, Abdirahman Said, Karataş Mesut, Öcal Lütfi, Hassan Mohmed Omar, Awad Ikram, Sheikh Hassan Mohamed
Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Admas University, Borama, Somalia.
Ann Med Surg (Lond). 2022 Nov 6;84:104830. doi: 10.1016/j.amsu.2022.104830. eCollection 2022 Dec.
Hypothyroidism can cause a variety of manifestations, including cardiovascular disorders. The most frequent clinical signs are sinus bradycardia and pericardial effusion. The affected patient generally has significant symptoms. Hypothyroidism infrequently results in a complete atrioventricular block.
A 19-year-old girl presented to our cardiology clinic with generalized tiredness, edema in her lower limbs and face, constipation, and a menstruation abnormality in the previous six months. With a normal ejection fraction on echocardiography, an electrocardiogram revealed complete atrioventricular block. When she was admitted, her laboratory testing showed that she had severely raised Thyroid Stimulating Hormone (TSH) levels, severe dyslipidemia with normal electrolytes, and normal liver and kidney function tests. The patient was treated with 50mg Thyroxine to her. She had significant improvement within two weeks of treatment. Up on the next follow-up (at one-month), her electrocardiogram returned to normal sinus rhythm without any evidence of atrioventricular block and that the lipid profile had returned to normal.
In its first stages, hypothyroidism can not show any obvious symptoms. Untreated hypothyroidism over time can lead to a variety of health issues, including obesity, joint discomfort, infertility, and heart disease. This current case demonstrates how levothyroxine medication successfully managed a young female patient's severe hypothyroidism, difficult total heart block, severe hyperlipidemia, and long-standing menstrual irregularity.
We found that overt hypothyroidism caused a complete atrioventricular block and severe dyslipidemia, and that thyroxin therapy completely corrected both conditions.
甲状腺功能减退可引起多种表现，包括心血管疾病。最常见的临床体征是窦性心动过缓和心包积液。受影响的患者通常有明显症状。甲状腺功能减退很少导致完全性房室传导阻滞。
一名19岁女孩因全身疲倦、下肢和面部水肿、便秘以及过去六个月的月经异常前来我们的心脏病诊所就诊。超声心动图显示射血分数正常，但心电图显示完全性房室传导阻滞。入院时，她的实验室检查显示促甲状腺激素（TSH）水平严重升高、血脂严重异常但电解质正常，肝肾功能检查正常。给予患者50mg甲状腺素进行治疗。治疗两周内她有显著改善。在下次随访（一个月时），她的心电图恢复为正常窦性心律，没有任何房室传导阻滞的迹象，血脂也恢复正常。
在甲状腺功能减退的早期阶段，可能不会出现任何明显症状。随着时间的推移，未经治疗的甲状腺功能减退会导致各种健康问题，包括肥胖、关节不适、不孕和心脏病。本病例展示了左甲状腺素药物如何成功治疗一名年轻女性患者的严重甲状腺功能减退、难治性完全性心脏传导阻滞、严重高脂血症和长期月经不调。
我们发现显性甲状腺功能减退导致了完全性房室传导阻滞和严重高脂血症，而甲状腺素治疗完全纠正了这两种情况。
