Graves Disease Presenting With Right Heart Failure Resulting From Pulmonary Hypertension

摘要

The association between thyroid dysfunction and pulmonary arterial hypertension (PAH) has been described since the 1980s. The prevalence of autoimmune thyroid disease (AITD) in patients with primary pulmonary hypertension (PPH) has recently been reported to be very high (46%). Conversely, patients with AITD and symptoms suggestive of thyrotoxic cardiac failure may actually have PPH. Recognition of this may prompt endocrinologists treating these patients to investigate for underlying PPH in those patients whose cardiovascular and respiratory symptoms fail to resolve after euthyroidism is achieved. We describe a patient with Graves disease (GD) and uncontrolled thyrotoxicosis who presented with symptoms suggestive of right heart failure, which were initially attributed to thyrotoxic cardiac failure. Further investigations revealed the presence of PPH, which only partially resolved after treatment of GD.