Why the study?
Graves' disease can cause cardiovascular complications, but cardiomyopathy is rare, highlighting the need for complete evaluation in unexpected presentations.
This case demonstrates that Graves' cardiomyopathy can present as acute heart failure unmasked by blunt chest trauma and is completely reversible with appropriate antithyroid therapy.
Graves' disease cardiomyopathy may mimic blunt cardiac injury; this Level 5 case leaves open the need for thyroid evaluation in unexplained post-traumatic heart failure.
Graves' disease can manifest with numerous cardiovascular complications, although very few cases result in cardiomyopathy. Our patient presented following a motor vehicle accident where she suffered blunt chest trauma. Her initial presentation was concerning for acute heart failure due to blunt cardiac injury, with diffuse pulmonary edema, hemodynamic instability, and an acutely reduced ejection fraction with global hypokinesis on transthoracic echocardiography. On further evaluation with thyroid function testing and autoimmune studies, she was found to have uncontrolled Graves' disease. She was subsequently started on methimazole for her Graves' cardiomyopathy. Following discharge, an outpatient cardiac MRI revealed no late gadolinium enhancement and complete recovery of her ejection fraction to normal values. This case serves to highlight the importance of a complete evaluation of cardiomyopathy and highlights an interesting case of a patient with blunt chest injury with a background of undetected Graves' cardiomyopathy.
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Karan et al. (2023) studied this question.
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