International Journal of Contemporary Medicine

To study the association of thyrotoxicosis with various cardiac parameters among north Indian population.

50 cases of thyrotoxicosis aged 18 to 60 years were included in the study along with 50 age matched healthy controls. Detailed clinical examination along with relevant laboratory investigations including thyroid profile was done. Two-dimensional Echocardiography was done to look for right ventricular (RV) dimensions, right ventricular outflow (RVOT) dimensions, Right ventricular fractional area change (FAC), Tricuspid annular plane systolic excursion (TAPSE) and to look for presence of pulmonary hypertension and valvular regurgitations. Echocardiographic parameters were compared between the cases and controls.

Out of 50 cases of thyrotoxicosis, 40 were females. The maximum clustering of cases of thyrotoxicosis is seen between age group of 35 to 45 years (36%). Palpitations are the most predominant symptom and tachycardia was the most common sign. Atrial Fibrillation (AF) was seen in five patients. Two patients presented with Heart Failure on admission. On 2D- Echocardiography, right ventricular dimensions like basal RV diameter, mid RV diameter, base to apex RV diameter, RVOT dimensions and TAPSE was significantly increased in the cases as compared to controls. Right ventricular FAC was significantly reduced in cases as compared to controls. 22 cases had mild Tricuspid Regurgitation (TR), 3 cases had moderate TR and one had severe TR. Ten cases had pulmonary artery systolic pressure (PASP) >35mm Hg.

Although tachycardia and atrial fibrillation are common in thyrotoxicosis, but it also has significant effect on right heart dimensions and untreated can lead to pulmonary hypertension.