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Issue 128 Summer 2018

Endocrinologist > Summer 2018 > Hot topics

A neglected presentation of thyrotoxicosis

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Thyrotoxicosis is associated with cardiac dysfunction: more commonly, left ventricular dysfunction. However, in recent years, there have been more cases reported regarding right ventricular dysfunction, often associated with pulmonary hypertension, in patients with thyrotoxicosis.


Shalini Singarayar et al. present the largest case series so far, in an attempt to establish the common clinical features, echocardiographic parameters and clinical course of right ventricular dysfunction and thyrotoxicosis. The echocardiography for almost all cases revealed dilated right atrial and/or ventricular chambers, with elevated pulmonary artery pressure, but such parameters can be resolved by rendering the patients euthyroid.

Right ventricular dysfunction and pulmonary hypertension are not well-recognised complications of thyrotoxicosis, but they can be reversed with early recognition and treatment of thyrotoxicosis. Signs and symptoms of right ventricular dysfunction should be sought in all patients with newly diagnosed thyrotoxicosis, and prompt restoration of euthyroidism is warranted in affected patients before development of overt right heart failure.

Read the full article in Endocrinology, Diabetes & Metabolism Case Reports EDM180012.

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