Congestive heart failure in subjects with thyrotoxicosis in a black community

Abstract

R C Anakwue, B J C Onwubere, B C Anisiuba, V O Ikeh, A Mbah, S O IkeDepartment of Medicine, College of Medicine, University of Nigeria Enugu CampusIntroduction: Thyroid hormone has profound effects on a number of metabolic processes in virtually all tissues but the cardiovascular manifestations are prominent usually creating a hyperdynamic circulatory state. Thyrotoxicosis is not a common cause of congestive heart failure among black communities.Objectives: To determine the hospital prevalence, clinical characteristics and echocardiographic findings in patients with thyrotoxicosis who present with congestive heart failure (CCF) in the eastern part of Nigeria.Subjects and methods: A total of 50 subjects aged 15 years and above who were diagnosed as thyrotoxic following clinical and thyroid function tests were consecutively recruited. Fifty age- and sex-matched controls with no clinical or biochemical evidence of thyrotoxicosis and no comorbidities were used as controls. Two-dimensional echocardiography was carried out on all the subjects. CCF was determined clinically and echocardiographically.Results: Eight patients (5 females and 3 males) out of a total of 50 thyrotoxic patients presented with congestive heart failure.Conclusion: The study revealed that congestive heart failure can occur in thyrotoxicosis in spite of the associated hyperdynamic condition. The underlying mechanism may include direct damage by autoimmune myocarditis, congestive circulation secondary to excess sodium, and fluid retention.Keywords: thyrotoxicosis, congestive heart failure, echocardiography, black community