Key result
Achieving a euthyroid state completely reversed hypothyroid cardiomyopathy, which had presented with septal asymmetric hypertrophy and a strain pattern mimicking cardiac amyloidosis.
Case Report (n=1)
Severe hypothyroidism can present with reversible echocardiographic findings that mimic hypertrophic cardiomyopathy or cardiac amyloidosis.
May prompt thyroid screening in unexplained hypertrophic or amyloid-like strain patterns; leaves open generalizability beyond this case.
We present the case of a 46-year-old patient with hypothyroidism secondary to Hashimoto's thyroiditis who was admitted with decompensation in the form of myxedema. A 2-D echocardiogram shows a septal asymmetric hypertrophy, with low-voltage QRS complex in the ECG and a bull's-eye map of longitudinal strain with preserved apical strain with reduction of mid and basal strain that results in "cherry on the top" pattern, similar to the most frequent phenocopy of hypertrophic cardiomyopathy, as is the cardiac amyloidosis, and that, unlike this pathology, reverted after the patient reached the euthyroid state.
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Cianciulli et al. (2021) conducted a case report in Hypothyroid cardiomyopathy (n=1). Euthyroid state achievement was evaluated on Reversibility of cardiomyopathy features. Achieving a euthyroid state completely reversed hypothyroid cardiomyopathy, which had presented with septal asymmetric hypertrophy and a strain pattern mimicking cardiac amyloidosis.
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