Hypothyroidism in disguise: A tale of heart, pituitary, and acromegaloid manifestations

Hypothyroidism, a common endocrine disorder, when left untreated may result in pseudoacromegaly, dilated cardiomyopathy, and pituitary hyperplasia. Hypothyroidism is a recognized cause of reversible dilated cardiomyopathy, with heart failure improving upon treatment with levothyroxine. Long-standing untreated primary hypothyroidism can also result in pseudoacromegaly, which resolves with thyroxine supplementation. We report a case of long-standing untreated primary hypothyroidism presenting with acromegaloid features, heart failure, and pituitary hyperplasia, all of which improved following thyroxine therapy.