Cardiac Manifestation among Patients with Hypothyroidism - A Cross-Sectional Study in North Karnataka

Author(s): Swetha Rajshekar Lakshetty1, Nandini Devru2

Hypothyroidism is the second most common endocrinopathy next to diabetes
mellitus (DM). Hypothyroidism is associated with increased cardiovascular
mortality and morbidity. Cardiovascular complications are some of the most
profound, reproducible and reversible clinical findings associated with thyroid
disease1. Hence this study was undertaken to assess the cardiac dysfunction
among patients with hypothyroidism by electrocardiogram (ECG) and
echocardiogram (ECHO) so as to provide a proper treatment guideline even among
milder cases.
This was a cross sectional study carried among 50 new patients of hypothyroidism
who presented to Navodaya Hospital, Raichur during 2015 to 2017. They were
clinically evaluated and underwent relevant investigations, including thyroid profile
estimation, cardiac evaluation using ECG and 2D ECHO.
Most cases fell in the age group of 31 - 40 years. There was an overall female
preponderance (76 %) over all age groups with mean age of 42.02 years. Goiter
was found in 8 % of patients, bradycardia and hypertension was seen in 30 % and
22 % respectively. Central nervous system (CNS) examination revealed delayed
ankle jerk in 40 % followed by hoarseness of voice in 38 % of patients. Lipid
analysis showed increase of total cholesterol (TC), low density lipoprotein (LDL),
very low-density lipoprotein (VLDL), triglycerides (TGL) and decrease of highdensity
lipoprotein (HDL). Normal ECG was found in 26 % of patients. Bradycardia
was most common finding seen in 30 % (15) of patients. 24 % (12) of patients
exhibited low voltage complexes. While, 46 % cases showed normal ECHO
findings. 24 % of cases presented with pericardial effusion. 18 % cases presented
with diastolic dysfunction among which majority were mild. None of the cases had
severe diastolic dysfunction. Only a meagre 10 % cases showed intraventricular
septum (IVS) thickness.
Pericardial effusion was seen among 24 % of patients while diastolic dysfunction
was seen in 18 % patients. Thus, any unexplained pericardial effusion should be
screened for hypothyroidism.