A CLINICAL STUDY OF CARDIOVASCULAR CHANGES IN HYPOTHYROIDISM

Abstract

Background-Hypothyroidism is a clinical syndrome resulting from deficiency of thyroid hormones, which in turn results in generalised slowing down of metabolic processes.¹  Hypothyroidism is second most common endocrinopathy next to diabetes mellitus. Apart from other complications Cardiovascular complications² are  the most profound and reproducible clinical findings associated with thyroid disease. The cardiovascular complications ranges from functional systolic/diastolic dysfunction to overt heart failure and coronary artery disease. Hypothyroidism leads to changes in cardiac contractility, myocardial oxygen consumption, cardiac output, blood pressure and systemic vascular resistance. A variety of case reports demonstrated that hypothyroidism may cause prolongation of QT interval. They can develop protein rich pericardial effusion.⁶Hypothyroidism is an important individual and public health issue. The completely reversible nature of these complications is well known that lead to the need of this study  to assess the Cardiovascular parameters in newly diagnosed hypothyroid patients and patients on treatment by performing various investgations including Echocardiography.

Aims & objectives-To evaluate the echocardiographic changes in newly diagnosed patients and patients who are taking treatment. To find out the incidence of cardiac dysfunction in newly diagnosed hypothyroid patients and the patients who are on treatment.

Material & methods- 25  newly detected hypothyroidism and 25 known cases of hypothyroidism who are on treatment for less than 4 months  were taken for study, Cases were undergone for cardiovascular examination including electrocardiography and echocardiography. All  patient’s examination records were  collected by using structured schedule (Case Report Form) and data  entered in Microsoft Excel Sheet and analysed by using SPSS SOftware.

Results-Hypothyroidism is more common in females as compare to male. Majority of study population (34%) belonged to 21-40 years of age group. Most common clinical symptoms found were  easy fatiguability (62%)  ,body swelling (42%)  , weight gain (38%)  BMI more than 25 (34%) and dry skin (32%). Among 50 cases 30 (60%) cases had  normal electrocardiographic changes.⁷ normal Echocardiographic study was observed in 20(40%) of cases. Most common  Echocardiographic  finding was Grade-I & Grade-II diastolic dysfunction that was found in 16 (32%) cases. Other abnormal finding were pericardial effusion found in 10% cases , Increased LV thickness (8%) and LVH (8%)  followed by systolic dysfunction.

Conclusion- This study suggest that it is very important to evaluate patients of primary hypothyroidism for cardiovascular changes. prior cardiovascular investigation should be performed to improve the clinical outcomes.