Some hypothyroid patients will develop a cardiomyopathy which usually responds to appropriate hormone replacement therapy.
Hypothyroidism is associated with (Dharmasena et al):
(1) depressed chronotropy
(2) increased peripheral vascular resistance
(3) decreased cardiac contractility
(4) decreased cardiac output
Clinical features of hypothyroid cardiomyopathy:
(1) hypothyroidism
(2) systolic and diastolic dysfunction
(3) heart failure
(4) left and right ventricular dilatation
(5) cardiac arrhythmias (bradycardia, torsades de pointes, other)
(6) systemic hypotension which may progress to cardiogenic shock
(7) improvement after thyroxine replacement
(8) exclusion of other causes for the cardiomyopathy
Hypothyroidism may be associated with coronary artery disease and atherosclerosis, so ischemic cardiomyopathy needs to be differentiated from myocyte dysfunction secondary to hypothyroidism.
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