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2019, vol. 72, br. 11-12, str. 379-382
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Hipotiroidizam kao uzrok reverzibilne dilatativne kardiomiopatije - prikaz slučaja
Hypothyroidism as the cause of reversible dilated cardiomyopathy: A case report
aUniverzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti bKlinički centar Vojvodine, Klinika za gastroenterologiju i hepatologiju, Novi Sad cUniverzitet u Novom Sadu, Medicinski fakultet + Institut za onkologiju Vojvodine, Sremska Kamenica dUniverzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti + Univerzitet u Novom Sadu, Medicinski fakultet
e-adresa: vanja.drljevic.todic@ikvbv.ns.ac.rs
Sažetak
Uvod. Etiolološki činioci za nastanak dilatativne kardiomiopatije najčešće se dele na ishemijske i neishemijske. Iako je važnost tiroidnih hormona za adekvatno funkcionisanje kardiovaskularnog sistema dobro poznata, dilatativna kardiomiopatija je retka prezentacija hipotiroidizma. Prikaz slučaja. Prikazali smo slučaj 38-godišnjeg muškarca primljenog u jedinicu intenzivne kardiološke nege sa simptomima i znacima uznapredovale srčane slabosti. Ehokardiografski registrovana je dilatativna kardiomiopatija, dok su laboratorijskim testovima utvrđene visoke vrednosti tirostimulišućeg hormona i niske vrednosti slobodnog trijodtironina i slobodnog tiroksina. Ejekciona frakcija značajno je poboljšana nakon uvođenja terapije levotiroksinom. Zaključak. Hipotiroidizam uvek mora bit razmotren kao uzrok dilatativne kardiomiopatije. Ispitivanje tiroidnih hormona treba uraditi kod svih pacijenata sa dilatativnom kardiomiopatijom.
Abstract
Introduction. The causes of dilated cardiomyopathy can be divided into ischemic and nonischemic. Although the importance of thyroid hormones for proper functioning of the cardiovascular system is well known, dilated cardiomyopathy is a rare presentation of hypothyroidism. Case Report. This is a case report of a 38-year-old man admitted to the Intensive Cardiac Care Unit with signs and symptoms of advanced heart failure. Dilated cardiomyopathy was established by echocardiography, while blood test showed highly elevated levels of thyroid stimulating hormone and decreased levels of free triiodothyronine and free thyroxine. The ejection fraction was significantly improved with levothyroxine replacement therapy. Conclusion. Hypothyroidism should always be considered as the cause of dilated cardiomyopathy. Thyroid hormone tests should be performed in all patients with dilated cardiomyopathy.
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