A study of cardiovascular manifestation in patient with hypothyroidism

ABSTRACT

Background: Reduced production of thyroid hormone is the central feature of the clinical state termed Hypothyroidism. Hypothyroidism is associated with bradycardia, a decreased cardiac output, increased vascular resistance and perhaps a decreased sensitivity of the sympathoadrenal system. Aim and objective: To assess the cardiovascular functions in diagnosed hypothyroidism patients. Materials and methods: A total number of 70 hypothyroid patients were enrolled in this study. The clinical features, cardiovascular manifestations were studied by ECG, ECHO, chest X-ray lipid profiles. Results: Most of the cases fell in the age group of 31-40 years at a percentage of 52.9%. On analysis of 70 cases, 41% of cases were in moderate hypothyroidism group. On analyzing the pulse rate of 34% of the cases had bradycardia (PR <60/min). Mean BP- 131/84 mm Hg (Range 118-166/66 – 102 mm Hg). Most of the patients fell into the pre-HT group which was around 66%. 24% of hypothyroid patients were hypertensive (BP >140/90 mm Hg). Lipid analysis in hypothyroid patients showed an increase in total cholesterol. 54.3% of patients had hypercholesterolemia (> 300 mg/dL). On analyzing the ECG changes in hypothyroid patients the most common finding was sinus bradycardia. It was found in 39% of cases. Next was low voltage complex which is around 34%. Normal ECG was found in 14% of patients. Least common findings were ST-T changes, RBBB and LBBB. Out of 70 cases, 12 (17.14%) patient showed enlarged cardiac silhouette (cardiomegaly). 34% of the patients had pericardial effusion. 30 % of the patients had diastolic dysfunction. Systolic dysfunction occurred in 4.3% of them, while IVST and LVPWT were seen in 14.3% and 12.9% respectively. Conclusion: Any unexplained diastolic dysfunction or pericardial effusion should be screened for hypothyroidism. Early detection of hypothyroidism and proper replacement therapy found to reverse the cardiovascular complications and thereby can decrease the morbidity and mortality.