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JPY
Abstract
The patient was a 56 –year–old man. He presented to a local clinic with pedal edema. Echocardiography showed preserved left ventricular systolic function and the enlarged right side of the heart (estimated right ventricular systolic pressure, 68.1 mmHg). He was thus diagnosed with pulmonary hypertension and referred to our hospital for detailed evaluation in October 2011. The patient had a previous medical history of chronic atrial fibrillation. Imaging examinations, including computed tomographic pulmonary angiography and ventilation/perfusion scintigraphy, showed no specific findings. Then, Swan–Ganz catheterization was performed for the assessment of pulmonary function, resulting in obvious pulmonar y hypertension (pulmonar y arterial pressure, 66/14/31mmHg). The cardiac index was 7.41 L/min/m2, suggesting that the patient should have hyperdynamic state. The hematological evaluation resulted in hyperthyroidism with positive anti –thyroglobulin antibody, anti–thyroid peroxydase antibody and thyroid stimulation hormone receptor antibody. Thyroid echography also revealed thyromegaly and increased blood flow to the thyroid gland. Although the patient was suspected Basedow disease, thyroid scintigraphy revealed a pattern of silent thyroiditis. The patient still remains under treatment with potassium iodide. No specific cause of pulmonar y hypertension can be found except hypethyroidism. Here, we present a case in which we identified hyperthyroidism while searching the etiology of pulmonary hypertension.
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