The cardiovascular system is the main target organ of thyroid hormone. Overt hypothyroidism decreases myocardial contractility, and diminished myocardial contractility reduces thyroid hormone metabolism. 32 years old woman comes for consultation to cardiologist with complaints: swelling mainly of the face and upper extremity, difficulty breathing and dysritmia, dry skin. These changes started about 2 weeks ago. By anamnesis shown that about 2 years ago conducted a tonsillectomy, preoperative examinations with any pathological changes. Is not married, never been pregnant and does not take any contraceptives. Cardiologist did the ECG and echocardiography, they were found impaired left ventricular ejection fraction, the negative T wave in I, II, aVF, V4-6. A small amount of free fluid in the both pleural, C-reactive protein in normal, by blood chemistry hypo chromic anemia, blood plasma BNP(B-type natriuretic peptide) – 225pg/ml (N - <130ng/ml), Troponin I <0.1ng/dl (N- <0.1ng/dl).
Suspected that patient has hypothyroidism, by ultrasound research main volume - 39.9 ml, thyrotrophic hormone (TSH) - 63.3 (N-0.27-4.2mIU/L) and FT4 - 0.1 (N-1.0 – 1.6 ng/dl) they was diagnosed primary hypothyroidism. We start replacement therapy with increasing doses of levothyroxine to 100mkg. After compensation of hypothyroidism left ventricular ejection fraction returned to normal levels, ECG changes are corrected, free fluid in the pleural not observed all complaints disappeared. Patient continues treatment with levothyroxine. We will look after in dynamic. In conclusion, as seen cardiovascular changes are reversible when the underlying thyroid disorder is recognized and treated.