Unraveling the cardiac consequences of hypothyroidism: a case report of sinus arrest and bradycardia exacerbated by seasonal changes, escitalopram and medication noncompliance

TL;DR

A 53-year-old woman with hypothyroidism experienced severe heart rhythm issues that improved with treatment and highlights the need for timely management.

Contribution

This case report highlights the exacerbation of hypothyroidism-related cardiac arrhythmias due to multiple contributing factors.

Findings

The patient's prolonged sinus arrest resolved with temporary pacing and levothyroxine therapy.

Seasonal changes, medication noncompliance, and escitalopram use likely worsened her condition.

Prompt recognition and treatment of hypothyroidism can reverse cardiac complications.

Abstract

Thyroid hormone is essential in human metabolism. Hypothyroidism causes bradycardia, sinus pause, sinus arrest, and the most severe form, myxedema coma, and cardiopulmonary arrest. Most cardiovascular manifestations secondary to hypothyroidism are reversible with timely thyroid hormone replacement. Herein, we report a case of a 53-year-old woman with hypothyroidism who experienced episodes of prolonged sinus arrest, which resolved following temporary pacing and initiation of levothyroxine therapy. Factors such as seasonal variation, medication noncompliance, recent viral illness, and concurrent escitalopram use likely contributed to her presentation. This case highlights the importance of prompt recognition and management of hypothyroid-related cardiac arrhythmias.

Figures