Pattern and Presentation of Thyro-Cardiac Disease among Patients with Hyperthyroidism Attending a Tertiary Hospital in Ethiopia: A Cross Sectional Study

Abstract

Background: Thyro-cardiac disease describes the existence of a combination of thyroid toxicity and significant heart disease in an individual patient. The frequent manifestations of thyro-cardiac disease are hypertension, atrial flutter or fibrillation, pulmonary hypertension and dilated cardiomyopathy. The aim of the study was to determine the pattern and presentation of cardiovascular diseases in patients with hyperthyroidism on follow-up at St. Paul's Hospital endocrine clinic. Methods: It was a hospital based cross sectional study that evaluated hyperthyroid patients' on follow-up at St. Paul's Hospital for cardiovascular diseases from May 1st 2017 to October 31st 2017. They had focused history, physical examination, electrocardiographic and echocardiographic evaluation. Results: A total of 146 hyperthyroid patients on follow-up were included in the study. The mean age was 47.2 years and females accounted for 93.2% of patients. The mean duration of symptoms before presentation was 42 months. The frequent causes of hyperthyroidism were toxic multi-nodular goitre (88.4%), Graves' disease (6.8%) and toxic adenoma (2.1%). Sixteen (11%) patients had atrial fibrillation and 71 (48.6%) had hypertension. Thyrocardiac disease was detected in 46.6% of patients. The frequent abnormalities were left ventricular hypertrophy (14.4%), mild diastolic dysfunction (10.9%), moderate to severe mitral regurgitation (8.9%), pulmonary hypertension with or without right ventricular dysfunction (8.2%) and dilated cardiomyopathy (4.1%). Conclusion: Cardiovascular disease was frequent among patients with hyperthyroidism. The commonest abnormalities were systemic hypertension, pulmonary hypertension with or without isolated right sided heart failure, atrial fibrillation and dilated cardiomyopathy.