Endocrine Abstracts

Introduction: The occurrence of Dilated Cardiomyopathy (DCM) and hypothyroidism induced systolic dysfunction is rare, especially when it presents as an initial manifestation of hypothyroidism Case We report the case of a 57-year-old patient, a known chronic smoker, who was admitted to the emergency department reporting asthenia, NYHA class III dyspnea, cardiac angina, and periorbital oedema. The ECG reveals a regular rhythm at 50 bpm and diffuse low voltage with firstdegree atrioventricular block. Biologically, the initial assessment showed normal renal and hepatic function. TSH was elevated at 228 mIU/l, T4 was low, and anti-TPO and anti-TG were significantly positive. Cervical ultrasound findings pointed towards a pseudo-nodular thyroid indicative of thyroiditis, along with features of bi-ventricular dilated cardiomyopathy presenting moderate left ventricular dysfunction and an ejection fraction of 45% on echocardiography. The Coronary angiography yielded normal results, while cardiac MRI revealed dilated cardiomyopathy with a dilated left ventricle. The patient underwent heart failure management, with a stepwise introduction of thyroid hormone replacement therapy using L-thyroxine, leading to a favorable clinical, biological, and radiological progression

Discussion: Dilated cardiomyopathy is a weakening and stretching of the heart muscle, resulting in a diminished capacity for effective blood pumping. Although it can have diverse factors, such as genetic causes, viral infections, and metabolic issues, it can also have an association with thyroid disorders, including hypothyroidism. Treating hypothyroidism can enhance cardiac function gradually in numerous cases.