DIFFERENT CARDIOVASCULAR MANIFESTATIONS OF PRIMARY HYPOTHYROIDISM IN SULAIMANI TEACHING HOSPITAL 

Amanj Abubakr Khaznadar a and Aiman Muhammed Mareay b




a Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 
b Sulaimani Directory of Health and Kurdistan board Candidate, Kurdistan Region, Iraq.



Submitted: 1/6/2019; Accepted: 25/2/2020; Published: 21/3/2020
ABSTRACT


Background 

Hypothyroidism is a common clinical condition of variable prevalence in different regions that has significant effect on cardiovascular function. Deficiency of thyroid hormones can cause great changes in cardiovascular hemodynamics and regulation of cardiac function. Hypothyroidism directly influences vascular smooth muscles, provokes diastolic hypertension, changes coagulability, and increases the circulation level of highly atherogenic low-density lipoprotein (LDL) cholesterol particles, which consequently leads to an increase in the risk of atherosclerotic cardiovascular diseases. 


Objectives

To identify the different cardiovascular manifestations and complications of primary hypothyroidism. 


Patients and methods

A cross-sectional retrospective study was carried out at Sulaimani Teaching Hospital in Sulaimani city, the Kurdistan Region of Iraq from July, first 2018 to Jun, first 2019. A total number of 103 patients were recruited in the study, of whom, 93 were females and 10 were males. The patients’ age ranged from (19 to 82) years. The patients were grouped based on their age, sex, residency, heart rate, blood pressure, BMI, and presence of other cardiovascular risk factors. All the participants were sent for thyroid function test (thyroid-stimulating hormone (TSH), and T4), electrocardiogram (ECG), and echocardiogram (Echo), with full history and clinical examination had been done.


Results

The total number of cases were (103) patients with primary overt hypothyroidism who received thyroxin therapy. Their age group was between (19 and 82) years with a mean age of 50.99. Female predominance is obvious with a female-to-male ratio of about 9:1. The results showed that the patients’ age, sex, and family history of cardiovascular diseases did not have a significant association with the incidence of hypothyroidism or euthyroid (p>0.05). 


Conclusions

Cardiovascular risk factors were found to be associated with euthyroid and hypothyroid. Both electrocardiogram (ECG) and echocardiogram (Echo) were significantly effective in detecting cardiovascular complications in patients with thyroid disorders. TSH level assessed through thyroid function test was found as the more reliable means of detecting thyroid diseases.



KEYWORDS

 Primary hypothyroidism, Echocardiogram, Electrocardiogram, Thyroid stimulating hormone.