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Case Reports: Reminder of important clinical lesson
Symptomatic and severe pulmonary hypertension due to hyperthyroidism
  1. Tadashi Itagaki1,
  2. Takashi Miura1,2,
  3. Toshio Kasai1 and
  4. Uichi Ikeda1
  1. 1Department of Cardiology, Nagano Municipal Hospital, Tomitake, Nagano, Japan
  2. 2Department of Internal Medicine and Cardiology, Miura Heart Clinic, Minamitakada, Nagano, Japan
  1. Correspondence to Tadashi Itagaki; itagaki{at}shinshu-u.ac.jp

Abstract

Hyperthyroidism has been recognised as the cause of secondary pulmonary hypertension (PH). However, several studies have reported that most PH cases due to hyperthyroidism are asymptomatic and not severe. Here, we report the case of a woman in her 30s with symptomatic and severe PH due to hyperthyroidism. She presented with a 2-month history of dyspnoea on exertion, palpitation and lower-extremity oedema. Echocardiography showed severe PH with estimated pulmonary arterial systolic pressure (ePASP) of 62 mm Hg. The diagnostic work-up showed severe PH due to hyperthyroidism. After treatment for hyperthyroidism, improvement of thyroid function contributed to a decrease in ePASP to 30 mm Hg. Similar to the present case, PH due to hyperthyroidism generally improves with the treatment of hyperthyroidism. Therefore, we must not overlook hyperthyroidism as a cause of PH and diagnose and start treatment for PH-causing hyperthyroidism at an early stage.

  • Thyroid disease
  • Hyperthyroidism
  • Pulmonary hypertension

https://doi.org/10.1136/bcr-2022-251120

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    Footnotes

    • Contributors TI: writing—original draft. TM : scientific advisors, writing—review and editing. TK and UI: scientific advisors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.