Endocrine Abstracts

Introduction

Cardiothyreosis is the most dreadful complication of hyperthyroidism. In Tunisia, cardiothyreosis has rarely been analyzed. The aim of our study was to describe the clinical aspects of this disease in an adult population of southern Tunisia.

Methods

Retrospective study (January 1999 to December 2018) including all cases of hyperthyroidism with cardiothyreosis followed in our department.

Results

100 cases of cardiothyreosis were collected with a prevalence of 16, 3%. Mean age was 49, 3 ± 13 years and sex ratio was 0, 75. The most common causes of hyperthyroidism were Grave’s disease (61%), Hashimoto thyroiditis (21%) and toxic multi-nodular goiter (11%). The delay of cardiothyreosis appearance was 18, 94 months and cardiothyreosis was inaugural in 54%. The most common symptoms of hyperthyroidism were weight loss (91%) and flushing (86%). The mean concentration of TSH and free T4 (FT4) were 0, 042 µUI/ml and 59, 6 pmol/l, respectively. Subclinical hyperthyroidism was found in 11% of patients. Hypocholesterolemia (85%) and hepatic cholestasis (80%) were the most frequent biological abnormalities. Echocardiographic findings showed low left ventricular ejection fraction in 44, 6%, pulmonary hypertension in 43% and right ventricular dilatation in 33.8% patients. Atrial fibrillation (AF) and cardiac heart failure (CHF) were the most noted manifestations of cardiothyreosis (75% and 56% patients, respectively). 37% of patients had concomitant AF and CHF. Those patients were significantly younger, have more anemia, hepatic cholestasis and pulmonary hypertension (P > 0.05).

Conclusion

The prevalence of cardiothyreosis is relatively frequent in our country. Cardiac complications are dominated by atrial fibrillation and CHF. Cardiothyreosis may occur in young patients and during subclinical hyperthyroidism.