A case report of Graves Thyrotoxicosis associated with Pulmonary Hypertension

Abstract

Abstract Introduction Pulmonary hypertension manifesting as a secondary cause has an extensive list of aetiology. Hyperthyroidism associated with pulmonary hypertension has been reported in a few case reports. Most of these have presented in an asymptomatic manner. A variety of mechanisms have been described in how thyrotoxicosis causes pulmonary hypertension. Case Presentation A 74-year-old woman with thyrotoxicosis due to Graves’ disease presented with bilateral pedal oedema and exertional shortness of breath suggestive of right heart failure. There was transthoracic echographic evidence of pulmonary hypertension. Commencement of oral carbimazole along with propranolol later once heart failure was controlled led to resolution complete resolution of pulmonary hypertension. Conclusion This case highlights the importance of considering thyrotoxicosis as a cause of pulmonary hypertension which can be completely resolved with the establishment of a euthyroid state. Although patients may present asymptomatic and are incidentally detected, the illness can manifest with features suggestive of right heart failure.