Waddankeri Swaraj S, Kohir Goutami V, Bijapur Karan J, Yelsangikar Goutam R, Patil Veeresh
Division of Diabetes and Endocrinology.
Department of Medicine, Mahadevappa Rampure Medical College.
Cardiovasc Endocrinol Metab. 2025 Jan 8;14(1):e00324. doi: 10.1097/XCE.0000000000000324. eCollection 2025 Mar.
Hypothyroidism is typically associated with bradyarrhythmias, but can rarely precipitate life-threatening ventricular arrhythmias. We present a case of severe hypothyroidism manifesting as polymorphic ventricular tachycardia (VT). A previously healthy woman in her early 50s presented with an acute onset of breathlessness and on examination had hypotension and tachycardia. ECG revealed polymorphic VT, promptly terminated by defibrillation using 200J biphasic shock. Investigations uncovered severe primary hypothyroidism (thyroid-stimulating hormone: 142 mIU/l) and left ventricular (LV) dysfunction with ejection fraction (EF) of 35%. Coronary angiogram was normal. Treatment with levothyroxine and standard heart failure therapy was initiated. In conclusion, at 3- and 6-month follow-ups, the patient remained asymptomatic and had no episodes of tachyarrhythmias without antiarrhythmic drugs, and her LV function normalized (EF: 55%). This case highlights the importance of considering hypothyroidism in patients presenting with unexplained ventricular arrhythmias.
甲状腺功能减退通常与缓慢性心律失常相关，但很少会引发危及生命的室性心律失常。我们报告一例以多形性室性心动过速（VT）为表现的严重甲状腺功能减退病例。一名50岁出头、既往健康的女性出现急性呼吸困难，检查发现有低血压和心动过速。心电图显示多形性VT，通过200J双相电击除颤迅速终止。检查发现严重的原发性甲状腺功能减退（促甲状腺激素：142 mIU/l）以及左心室（LV）功能障碍，射血分数（EF）为35%。冠状动脉造影正常。开始使用左甲状腺素和标准心力衰竭疗法进行治疗。总之，在3个月和6个月的随访中，患者无症状，未使用抗心律失常药物也未发生快速性心律失常事件，且其左心室功能恢复正常（EF：55%）。该病例强调了在出现不明原因室性心律失常的患者中考虑甲状腺功能减退的重要性。
