Hypothyroid As a Trigger for Heart Rhythm Disorders: A Case Report of Ventricular Tachycardia in a Hypothyroid Patient
DOI:
https://doi.org/10.11594/jk-risk.05.2.9Keywords:
Arrhythmia, Ventricular tachycardia, HypothyroidismAbstract
Hypothyroidism was associated with bradyarrhythmia, conduction abnormalities, impaired myocardial function, and ventricular arrhythmia. The prevalence of ventricular tachycardia in hypothyroid was 2.6%.
The patient was a 52-year-old woman who was experiencing palpitations, blurred vision, and syncope. ECG showed ventricular tachycardia (VT). Laboratory tests showed increased TSH and decreased T3 and FT4. Echocardiography showed global normokinetic, normal LV systolic function (EF 57%), normal RV systolic function, and normal heart chamber dimensions. DCA evaluation showed normal coronary artery. The patient underwent ablation of frequent PVCs originating from the anteroseptal RVOT. After ablation and hypothyroid treatment, there were no more VT episodes.
The pathophysiological mechanism underlying the relationship between hypothyroidism and cardiac arrhythmias was the regulatory effect of thyroid hormones on cardiovascular hemodynamics and cardiac ion channels. Thyroid hormones directly regulate the function of ion channels such as sodium, calcium, and potassium channels. Ion channel dysfunction can prolong ventricular repolarization, which can trigger VT.
This case report demonstrates the potential danger of thyroid dysfunction, especially hypothyroidism, in causing VT. Timely identification and treatment of hypothyroidism can prevent recurrence of arrhythmia and improve cardiac function.
Downloads
References
2. Ram N, Salik M. A Review of Arrhythmias in Endocrinology. Bangladesh Journal of Endocrinology and Metabolism. 2023;2:123-33. doi:10.4103/bjem.bjem_17_23.
3. Ahmad M, Reddy S, Barkhane Z, Elmadi J, Kumar LS, Pugalenthi LS. Hyperthyroidism and the Risk of Cardiac Arrhythmias: A Narrative Review. Cureus. 2022;14(4):2-9. doi:10.7759/cureus.24378.
4. Lee B, Lee WF, Lim BL. Rare case of Torsades de Pointes in severe hypothyroidism: literature review and challenges in management. International Journal of Emergency Medicine. 2022;15(11):1-4. https://doi.org/10.1186/s12245-022-00417-5
5. Bogdan C, Ivan VM, Apostol A, Sandu OE, Maralescu FM, Lighezan DF. Hypothyroidism and Heart Rate Variability: Implications for Cardiac Autonomic Regulation. Diagnostics. 2024;14:1-10. https://doi.org/10.3390/diagnostics14121261.
6. Pirga IA, Popescu ML, Ungureanu AL. Impact of untreated hypothyroidism on the cardiac conduction system: a case report and review of pathophysiology. Romanian Journal of medical Practice. 2024;19(1):79-83. doi:10.37897/RJMP.2024.1.13.
7. Marrakchi S, Kanoun F, Idriss S, Kammoun I, Kachboura S. Arrhythmia and thyroid dysfunction. Herz Cardiovascular Diseases. 2015;40:101-109. doi:10.1007/s00059-014-4123-0.
8. Ozcan EE, Dural M, Gorenek B. Tips for management of arrhythmias in endocrine disorders from an European Heart Rhythm Association position paper. Anatol J Cardiol. 2018;20:241-5. doi:10.14744/AnatolJCardiol.2018.87260.
9. Gluvic Z, Obradovic M, Stewart AJ, Essack M, Pitt SJ, Samardzic V, et al. Levothyroxine Treatment and the Risk of Cardiac Arrhythmias–Focus on the Patient Submitted to Thyroid Surgery. Frontiers in Endocrinology. 2021;12:1-12. doi:10.3389/fendo.2021.758043.
10. Ruocco JF, Gallego M, Yurre AR, Arrabal JZ, Echeazarra L, Alquiza A, et al. High Thyrotropin Is Critical for Cardiac Electrical Remodeling and Arrhythmia Vulnerability in Hypothyroidism. Thyroid. 2019;29(7):934-45. doi:10.1089/thy.2018.0709.
11. Esposito F, Liguori V, Maresca G, Cerrone A, Filippo OD, Trimarco B, et al. Subclinical Hypothyroidism A Reversible Cause of Complete Loss of Ventricular Lead Capture. Circ Arrhythm Electrophysiol. 2014;7(1):182-4. doi:10.1161/CIRCEP.113.001058.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Jurnal Klinik dan Riset Kesehatan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during the submission process, as it can lead to productive exchanges and earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
