Cardiovascular manifestation in hypothyroid patient: a cross-sectional study

Shahinul Alam; Muhammad Masrur Siam; M. Morshedul Alam Khan; Sadia Nusrat Ananya; D. M. Shajjad Hossain; M. Shah Alam; Fahmiah Begum

doi:10.18203/2320-6012.ijrms20254379

Authors

Shahinul Alam Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh
Muhammad Masrur Siam Department of Neurology, Dhaka Medical College Hospital, Dhaka, Bangladesh
M. Morshedul Alam Khan Department of Neurology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Sadia Nusrat Ananya Department of Neurology, Dhaka Medical College Hospital, Dhaka, Bangladesh
D. M. Shajjad Hossain Department of Neurology, Dhaka Medical College Hospital, Dhaka, Bangladesh
M. Shah Alam Department of Medicine and Gastroenterology, Ashulia Women and Children Hospital, Dhaka, Bangladesh
Fahmiah Begum Department of Physiology, Nilphamari Medical College, Nilphamari, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20254379

Keywords:

Hypothyroidism, Overt hypothyroidism, Subclinical hypothyroidism, Cardiovascular manifestations, ECG abnormalities

Abstract

Background: Hypothyroidism exerts widespread physiological effects, including significant cardiovascular alterations. Both overt and subclinical hypothyroidism can impair cardiac function, although the severity and pattern of abnormalities may differ. The aim of the study was to evaluate the spectrum of cardiovascular manifestations among hypothyroid patients attending a tertiary care hospital.

Methods: A total of 100 adults with newly diagnosed or previously known overt or subclinical hypothyroidism were enrolled. Patients with secondary hypothyroidism, major comorbidities, congenital or structural heart disease, chronic systemic illnesses, pregnancy, or relevant drug exposures were excluded. Clinical examination, ECG, and echocardiography were performed by trained cardiology specialists. Data were analyzed using SPSS-24.

Results: The mean age of the patients was 38.89±9.98 years, and 81% were female. Overt hypothyroidism was present in 67% of participants. Common cardiovascular symptoms included dyspnoea (21%), ankle swelling (16%), and chest pain (4%). Bradycardia (36%), hypertension (27%), pedal edema (19%), and diminished heart sounds (23%) were notable clinical signs. ECG abnormalities included bradycardia (41%), low-voltage complexes (38%), flat or inverted T waves (25%), and ST-segment changes (26%). Echocardiographic findings showed LVDD (21%), RWMA (20%), pericardial effusion (12%), systolic dysfunction (9%), and reduced ejection fraction (11%). ST-segment changes (p=0.021) and systolic dysfunction (p=0.022) were significantly more frequent in overt hypothyroidism.

Conclusions: Cardiovascular manifestations are common in hypothyroidism, with overt cases demonstrating more pronounced structural and functional abnormalities. Early detection and appropriate management are essential to prevent long-term cardiac complications.

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