P92 PERIMYOCARDITIS AS FIRST MANIFESTATION OF DYSTHYROIDISM: AN UNUSUAL CASE

Abstract Thyroid and cardiovascular system are inextricably related complications can occur in both subclinical overt thyroid dysfunction. We report the case of a 42–year–old woman presenting with chest pain. She had positive SARS–CoV–2 swab June she was hospitalised suspicion COVID–related pneumonia pericarditis July: treatment ibuprofen colchicine started patient discharged. On July 26th, came back to emergency department due worsening pain myalgias after therapy decalage. face edema hoarse voice. 12–leads EKG normal; echocardiography showed 8 mm pericardial effusion normal ejection fraction. Blood testing revealed no inflammatory signs, mild increase Troponin (peak value 19.1 ng/L, n.v. 0–14) high CPK 2299 U/L, 464 U/L at time discharge, 30–150). Moreover, biohumoral profile Hashimoto thyroiditis: severe hypothyroidism TSH levels (538 microU/ml peak value, 322 0.27–4.2) positivity autoantibodies. The underwent cardiac magnetic resonance imaging that suggestive for acute perimyocarditis biventricular diffuse myocardial edema, preserved function mild–to–moderate effusion. Low dose L–T4 together liothyronine stopped few days, once acceptable FT3 concentrations were obtained. At control we registered significant reduction (2 mm). Myocarditis is an disease myocardium it predominantly mediated by viral infection. A rare cause myocarditis represented dysthyroidism. In our case, seems be edema. failure diagnosis this endocrinological disorder determine delay specific possible serious manifestations. So, would reasonable check status all patients myopericarditis, absence another clearly identifiable aetiology. role prior infection not certain but quick recovery suggests low probability as SARS–CoV2 manifestation.