Korean Circ J.  2009 Apr;39(4):168-170. 10.4070/kcj.2009.39.4.168.

Isolated Pulmonary Arterial Hypertension-Janus' Faces of Hyperthyroidism

• Kang B
• Cho DK
• Byun KH
• Eun LY
• Cho YH

• KMID: 2225693
• DOI: http://doi.org/10.4070/kcj.2009.39.4.168

Abstract

We describe a 54-year-old woman with isolated pulmonary arterial hypertension accompanied by hyperthyroidism due to Graves' disease. Her pulmonary artery hypertension resolved spontaneously after restoration of euthyroidism. This case suggests that hyperthyroidism should be considered a reversible cause of pulmonary arterial hypertension.

Keyword

Hypertension, pulmonary; Hyperthyroidism; Graves disease

MeSH Terms

Female
Graves Disease
Humans
Hypertension
Hypertension, Pulmonary
Hyperthyroidism
Middle Aged
Pulmonary Artery
Hypertension, Pulmonary

Figure

• 

  Fig. 1 Echocardiography in a patient with isolated pulmonary arterial hypertension accompanied by hyperthyroidism. A: echocardiography on admission. The right atrium is markedly enlarged, and the right ventricle is compressing the left ventricle into a D-shape. The left ventricle is normal-sized. B: echocardiography after restoration of euthyroid state. The right atrial and ventricular sizes have normalized after resolution of hyperthyroidism. RV: right ventricle, LV: left ventricle, RA: right atrium, LA: left atrium.

• 

  Fig. 2 Chest computed tomography on admission. The thyroid gland is enlarged (white arrow), suggesting abnormal thyroid function.

Reference

1. Kahaly GJ, Dillman WH. Thyroid hormone action in the heart. Endocr Rev. 2005. 26:704–728.

2. Klein LI, Danzi S. Braverman LE, Utiger RD, editors. The cardiovascular system in thyrotoxicosis. Werner & Ingbar's The Thyroid: A Fundamental and Clinical Text. 2005. 9th ed. Philadelphia: Lippincott Williams & Wilkins;559–568.

3. Soroush-Yari A, Burstein S, Hoo GW, Santiago SM. Pulmonary hypertension in men with thyrotoxicosis. Respiration. 2005. 72:90–94.

4. Lozano HF, Sharma CN. Reversible pulmonary hypertension, tricuspid regurgitation and right-sided heart failure associated with hyperthyroidism: case report and review of the literature. Cardiol Rev. 2004. 12:299–305.

5. Ismail HM. Reversible pulmonary hypertension and isolated right-sided heart failure associated with hyperthyroidism. J Gen Intern Med. 2007. 22:148–150.

6. Ojamaa K, Balkman C, Klein IL. Acute effects of triiodothyronine on arterial smooth muscle cells. Ann Thorac Surg. 1993. 56(1):Suppl. S61–S66.

7. Siu CW, Zhang XH, Yung C, Kung AW, Lau CP, Tse HF. Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study. J Clin Endocrinol Metab. 2007. 92:1736–1742.