Dilated cardiomyopathy is an uncommon complication of hypothyroidism. Furthermore, nonpitting edema would be expected if all of our patient's signs and symptoms were secondary to hypothyroidism only; however, he had generalized pitting edema, which prompted us to further investigate for evidence of heart failure. Dilated cardiomyopathy secondary to hypothyroidism is uncommon, but clinicians should perform thyroid function tests in patients with unexplained dilated cardiomyopathy; cardiac dysfunction may be reversed with thyroid hormone replacement therapy. Although dilated cardiomyopathy is a common type of nonischemic cardiomyopathy, it is an uncommon cardiac complication of hypothyroidism, with only a few cases reported to date.[4],[5] Thus, epidemiological information is limited.[3],[5],[6] The exact mechanism of the development of dilated cardiomyopathy in patients with hypothyroidism remains unclear. [Extracted from the article]