Publication:

Heart failure related to hyperthyroidism in young woman

Acute decompensated heart failure is a clinical condition that is precipitated by underlying pathology, including thyroid disorders. The condition of hyperthyroidism can result in a hyperactive circulation, which can increase cardiac output and metabolic demands, ultimately leading to heart failure. A 35-year-old woman presented to the hospital with acute shortness of breath that increased during the night, as well as bilateral edema in the lower extremities, palpitations, and intermittent chest pain. According to the patient's medical history, hyperthyroidism was diagnosed two years ago; however, the patient has not adhered to the prescribed treatment. The physical examination shows low blood pressure (80/60 mmHg), tachycardia, and increased jugular venous pressure. Lung auscultation detects bilateral fine crackles. A decrease in ejection fraction is evident on echocardiography. The laboratory results indicated hyperthyroidism. Initial treatment includes a saline infusion, a dobutamine infusion, a high-dose furosemide drip, acetazolamide as an extra diuretic, clopidogrel, atorvastatin, isosorbide dinitrate under the tongue, sacubitril/valsartan, spironolactone, and enoxaparin. This case highlights the importance of recognizing the multifactorial nature of heart failure, especially in patients with hyperthyroidism.