Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

Rui Huang; Li Yan; Yuhua Lei; Yuanhong Li

doi:10.2147/IMCRJ.S296071

Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

Int Med Case Rep J. 2021 Mar 19:14:171-176. doi: 10.2147/IMCRJ.S296071. eCollection 2021.

Authors

Rui Huang^#¹, Li Yan^#², Yuhua Lei¹, Yuanhong Li¹

Affiliations

¹ Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi Prefecture, 445000, Hubei Province, People's Republic of China.
² Pediatrics Department, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi Prefecture, 445000, Hubei Province, People's Republic of China.

^# Contributed equally.

Abstract

Background: Thyroxine is closely related to cardiovascular diseases, such as coronary heart disease, ventricular arrhythmia, atrioventricular block, myocardial systolic weakness, pericardial effusion, low cardiac output and hypertension. Previous studies have also found that hypothyroidism can also lead to mental disorders. Here, we present a rare case of severe hypothyroidism patient accompanied by sick sinus syndrome (SSS) as a cardiovascular manifestation needing cardiac pacing and severe mental disorders.

Case presentation: A 42-year-old female patient, previously healthy, was referred to our hospital because of bradycardia complicated with sick sinus syndrome which requiring cardiac pacing and severe mental disorders. Her clinical features along with laboratory findings strongly suggested that the patient had severe hypothyroidism with sick sinus syndrome and mental disorders, both of which were reversible and successfully treated with levothyroxine.

Conclusion: This is the first reported case of hypothyroidism with sick sinus syndrome requiring pacemakers and psychiatric disorders, and the symptoms can be improved and reversed after thyroxine supplementation. This case highlights the importance of hypothyroidism screening when faced with unexplained psychosis or sick sinus syndrome, especially if combined.

Keywords: case report; hypothyroidism; psychiatric disorder; sick sinus syndrome.

Publication types

Case Reports

Grants and funding

This work was supported in part by the Health and Family Planning Commission of Hubei Province (CN) WJ2015MA021 and by the Graduate Education Innovation Project of Hubei Minzu University (MYG2020010) (Yuanhong LI). The funding bodies played no role in design of the study, collection, analysis, and interpretation of the data and in writing the manuscript.