Thyrotoxicosis presenting as exertional dyspnea and pulmonary hypertension: Case report and review of literature

OBJECTIVES In this case study, we describe a 35-year-old woman with pulmonary hypertension that was secondary to thyrotoxicosis who presented with exertional dyspnea. In the approach to exertional dyspnea, detailed physical examination and laboratory findings helped to get the diagnosis. METHODS Echocardiography showed right ventricular systolic pressure = 60 mmHg. A suppressed thyroid-stimulating hormone was seen in lab tests. The patient was treated with radioactive iodine. RESULTS Palpitations and shortness of breath improved, and both her thyroid-stimulating hormone and T4 levels decreased. Echocardiography and the pulmonary pressure were normal after treatment. CONCLUSIONS Thyrotoxicosis is one of the etiologies of pulmonary hypertension, but the exact etiology and pathogenesis remain unknown. Some patients may have symptomatic pulmonary hypertension that can be resolved by hyperthyroidism treatment.