Study of pulmonary hypertension using 2D echo in thyroid disorders

 

 

Abstract              Background: Though rare, thyroid dysfunction is known to cause Pulmonary Artery Hypertension (PAH) which is also known to be reversible by restoration of euthyroid state. Hence, timely diagnosis and institution of medications can prevent as well as treat the secondary PAH in these patients. Aim: To analyse the prevalence of PAH in newly diagnosed, treatment naïve patients with thyroid dysfunction (hypothyroidism/ hyperthyroidism) and to analyse the association of thyroid dysfunction with occurrence of PAH in treatment naïve patients. Furthermore, to see the improvement of PAH in those diagnosed, with treatment given, after 10 months. Materials and Methods: It was an observational prospective study which included 50 newly diagnosed patients with thyroid dysfunction. All were subjected to 2D echocardiography with detailed history and physical examination. Repeat echocardiographic assessment was done after 6 months of treatment for few patients to look for resolution of PAH. The statistical analysis was carried out to determine the association of PAH with thyroid dysfunction using student’s t-test and chi-square test of association. Results: The study included 37 (74%) females and 13 (26%) males. PAH was present in 11 (22%) patients. Repeat echocardiography after 10 months of treatment (Eltroxin 1.6 microgram/kg for hypothyroid patients and Carbimazole (5/10 mg BD/TDS for hyperthyroid) was performed (those who were diagnosed with PAH at the time of diagnosis of thyroid dysfunction) and reduction in Pulmonary Artery Systolic Pressure (PASP) was observed. Conclusion: High prevalence of PAH was observed in patients with thyroid dysfunctions at the time of diagnosis in the treatment naïve patients in the current study and it also reversed with treatment on repeat 2D-echo with treatment. It is, therefore, suggested that every patient of thyroid dysfunction should be screened for PAH, even though further studies are needed to substantiate this, due to an inherent small sample size of the study

Key Words - Hypothyroidism; Hyperthyroidism; Pulmonary hypertension.