Endocrine Abstracts

Introduction: Hypothyroidism is a rare cause of atrioventricular block. We report the case of an 85 year old patient admitted with a 3rd degree AVB and in whom the biological work-up had objectified a hypothyroidism.

Observation: 85-year-old patient, followed for thyreopathy for 20 years on LT4: 100 ug/d, Diabetic for 2 years on premixed regimen: 08-00-12 ui ;HTA for 5 years on amlodipine 5 mg/d presented to the emergency room for syncope. No signs of hypothyroidism, on clinical examination:Patient infiltrated;Hypertensive; bradycardic; polypneic; bilateral IMO, soft white, taking the cup reaching mid-leg; normal thyroid, on workup:CBC: hyperleukocytosis;TSH 9.22 ECG : Complete BAV Management was based on: increasing the dose of LT4 by 6.25 ug/d after cardiovascular evaluation; For diabetes: the patient was put on Lantus:10 ui 22h and rapid insulin according to capillary blood glucose

Discussion: The pathophysiology of atrioventricular block in hypothyroidism is not clear on the molecular level, the different clinical manifestations observed in hypothyroidism-associated cardiopathy can be explained by the genomic and non-genomic effects of thyroid hormones on cardiomyocytes

Conclusion: Evaluation of thyroid status is mandatory before any cardiac rhythm or conduction disorder