Severe primary hypothyroidism manifesting with torsades de pointes

The American Journal of the Medical Sciences
John B SchenckTu Lin

Abstract

Hypothyroidism can manifest with myriad cardiac abnormalities, often consisting of a combination of morphologic and functional changes. Low voltage, sinus bradycardia, and slowed conduction are usually found on electrocardiography. We describe a patient with severe hypothyroidism who presented with presyncope, prolongation of the QT interval, and polymorphic ventricular tachycardia (torsades de pointes). No other cause for the malignant ventricular ectopy was evident. With levothyroxine therapy, the QT interval normalized and the ventricular tachycardia was abolished. In addition to its commonly known cardiac effects, myxedema can predispose to the potentially life-threatening arrhythmia of torsades de pointes. Conversely, in patients presenting with QT interval prolongation and polymorphic ventricular tachycardia, hypothyroidism should be considered in the differential diagnosis.

References

Feb 1, 1976·Australian and New Zealand Journal of Medicine·C H Lim, P Lim
Jun 15, 1992·Proceedings of the National Academy of Sciences of the United States of America·P W LadensonA M Feldman
Apr 1, 1986·The American Journal of Cardiology·R A Pechter, L A Osborn
May 1, 1993·Circulation·R PolikarP Nicod
Apr 1, 1997·The American Journal of Cardiology·M H LehmannS L Rabinowe
Feb 15, 2001·The New England Journal of Medicine·I Klein, K Ojamaa
Jul 20, 2005·Treatments in Endocrinology·Nick Clarke, Udaya M Kabadi

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Citations

Mar 7, 2009·The New England Journal of Medicine·Nihar R DesaiRobert P Giugliano
Nov 8, 2008·Cases Journal·Mohammad Shojaie, Ahad Eshraghian
Jan 2, 2008·European Journal of Endocrinology·Fabio GalettaAlessandro Antonelli
Mar 27, 2015·BMJ Case Reports·Jesper FjølnerSøren Nielsen
Apr 29, 2014·Emergency Medicine Clinics of North America·Sarah B Dubbs, Ryan Spangler
Mar 27, 2012·The Medical Clinics of North America·Joanna Klubo-Gwiezdzinska, Leonard Wartofsky
Oct 24, 2009·Vascular Pharmacology·Narcis TribulovaTomas Soukup
Nov 28, 2006·Endocrinology and Metabolism Clinics of North America·Leonard Wartofsky
Apr 11, 2008·Journal of Cardiovascular Electrophysiology·Christopher R Ellis, Katherine T Murray
Nov 3, 2007·The American Journal of Medicine·Huy A Tran
Sep 24, 2011·Journal of Thyroid Research·Vivek MathewSubhankar Chowdhury
Jul 6, 2014·Herz·S MarrakchiS Kachboura
Sep 27, 2013·Journal of Intensive Care Medicine·Sara Danzi, Irwin Klein
Feb 8, 2007·The Annals of Pharmacotherapy·Krista M DaleC Michael White
Nov 26, 2009·Nature Reviews. Endocrinology·Janna Cohen-LehmanIrwin Klein
Jan 16, 2010·Journal of Clinical Psychopharmacology·Azita AlipourRex S Lott
Feb 14, 2007·Journal of Korean Medical Science·Kyoung Hee KweonChung Gu Cho
May 14, 2019·Thyroid : Official Journal of the American Thyroid Association·Anne R CappolaPaul W Ladenson
Sep 15, 2010·The Kaohsiung Journal of Medical Sciences·Volkan HanciIsil Ozkoçak Turan
Jan 16, 2008·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Oguzkaan UnalSazi Imamoglu
May 26, 2017·Case Reports in Endocrinology·Sonali Sihindi Chapa Gunatilake, Uditha Bulugahapitiya
Mar 23, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Bulent GorenekUNKNOWN ESC Scientific Document Group

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