Pattern Of Echocardiography Abnormalities In Thyrotoxic Patient On Follow Up At Jimma University Medical Center

Abstract

Background: Thyrotoxicosis is very common endocrine problem that affect all body systems and particularly are associated with clinically significant cardiovascular change which can be detected early by echocardiography. Longstanding hyperthyroidism results in serious cardiac complication with significant morbidity and mortality. But with early recognition and achievement of Euthyroidism the cardiac dysfunctions are reversible. Data regarding pattern of echocardiographic abnormalities in thyrotoxicosis are limited in the study area, which calls for urgent and systematic look into it. Objective: The main objective of this study is to determine pattern of Echocardiographic abnormalities in patient diagnosed with thyrotoxicosis on follow up at JUMC. Methods: hospital based prospective cross-sectional study was conducted on all patients diagnosed with thyrotoxicosis who come for follow up at medical and surgical clinic during the study period (Oct /2022- may/2023), and who fulfil the inclusion and exclusion criteria were included. Convenience sampling technique was used. After consent obtained, Questioner was employed to collect demographic data, clinical characteristic. Echocardiography was either done or for those who had Echocardiography done already within 3 months of TSH determination the existing Echocardiography result was used. After data quality is checked, then it was coded and entered into Epidata version 4.6.0.5 and exported to the (SPSS) version 23.0 for data analysis to determine characteristics of study subjects and pattern of echocardiographic abnormalities. RESULTS: A total of 114 hyperthyroid patients on follow-up were included in the study. The mean age was 45.32 years and females accounted for 71.1% of patients. The mean duration of symptoms before presentation was 36 months. The frequent causes of hyperthyroidism were toxic multi-nodular goiter in 91(79.8%), Graves’ disease in 16(14.0%), toxic adenoma in 3(2.6%), thyroiditis 2(1.8%) and thyroid cancer 2(1.8%) of the patients. The frequent echocardiographic abnormalities were, mild pulmonary hypertension (47%), mild mitral regurgitation (41%), and severe left ventricular hypertrophy (40%). Cardiac abnormalities were seven times more common in Thyrotoxic patients with anemia (p-value < 0.013). patients who had no follow up were five time more likely to have Cardiac abnormalities (p-value < 0.023), among comorbidities Thyrotoxic patients who have renal disease are four times more likely to have Cardiac abnormalities detectable by echocardiography (p-value < 0.023).