Dilated myocardiopathy, thoracic aorta dissection, and hypothyroidism: report of a case

• Autor: León Burgos, Alfonso Luis
• Formato: artículo
• Fecha de Publicación: 2023
• Institución: Colegio Médico del Perú
• Repositorio: Acta Médica Peruana
• Lenguaje: español
• OAI Identifier: oai:ojs.pkp.sfu.ca:article/2607
• Enlace del recurso: https://amp.cmp.org.pe/index.php/AMP/article/view/2607
• Nivel de acceso: acceso abierto
• Materia: Cardiomyopathy; Dilated; Aortic Dissection; Hypothyroidism

Hypothyroidism produces profound cardiovascular effects, being a rare cause of dilated cardiomyopathy; however, its association with aortic dissection is not well established. We report the case of a 48-year-old female patient, without comorbidities, who presented epigastric pain and dysphagia associated with dyspnea. Tomography revealed a Stanford type B aortic dissection, with severe dilatation of the left heart chambers; LVEF of 30% and pericardial effusion were observed on the echocardiography; and serum analysis showed TSH 157.6 uU/ml and FT4 0.10 ng/dL. The patient initiated treatment with bisoprolol 2.5mg/day, spironolactone 25mg/day, furosemide 40mg/day and levothyroxine 50ug/day. At her controls she manifested a decrease in her symptoms; and after 7 months, the echocardiography showed non-dilated chambers and LVEF of 58%, while TSH was 3.5uU/ml at the serum analysis. This case illustrates a rare event where three events as dilated cardiomyopathy, thoracic aortic dissection, and hypothyroidism concur.