An unusual presentation of thyrotoxicosis

Cardiac dysfunction in thyrotoxicosis is believed to arise from changes in preload, afterload, heart rate, and contractility. Cardiomyopathy is a less frequent cardiac complication linked to thyrotoxicosis. Here, we present a rare case of thyrotoxicosis induced cardiomyopathy in a 30-year-old male, where dilated cardiomyopathy manifested as the initial sign of thyrotoxicosis. The patient was treated with antithyroid drugs, diuretics and beta blockers. General surgery opinion obtained and planned to do thyroidectomy after euthyroid status. Patient was followed up and after 6 weeks was symptomatically better and was found to be euthyroid and repeat 2D ECHO showed an improvement in systolic function with EF of 55% and the patient was planned for thyroidectomy. In the management of thyrotoxicosis induced cardiomyopathy, pharmacological interventions involve the use of specific thyroid therapies such as thionamides (methimazole, carbimazole, propylthiouracil) and beta-blockers, coupled with heart failure management.