PDF(Pubmed)
Abstract：
Hypothyroidism can have a significant impact on cardiac contractility, vascular resistance, blood pressure, and cardiac rhythm. Ventricular arrhythmias induced by hypothyroidism are infrequently reported, especially in pediatric cases. A 15-year-old girl with autoimmune hypothyroidism experienced pulseless ventricular arrhythmias on 2 separate occasions because of nonadherence to levothyroxine medication. Subsequent investigations revealed an SCN5A mutation associated with Brugada syndrome. A loop recorder captured polymorphic ventricular tachycardia (PMVT), specifically Torsades de Pointes during her second event. Both arrhythmias were addressed only after stabilizing her thyroid hormone levels with replacement therapy. Although rare, patients with uncontrolled hypothyroidism may present with ventricular arrhythmias, particularly PMVT. The cornerstone of treatment for hypothyroidism-induced ventricular arrhythmia is thyroid replacement therapy. The identification of an SCN5A mutation unmasked by overt hypothyroidism emphasizes the need for a comprehensive cardiac evaluation in patients with hypothyroidism being assessed for PMVT.
摘要：
甲状腺功能减退症可以对心脏收缩力产生重大影响，血管阻力,血压,和心律。很少报道甲状腺功能减退引起的室性心律失常，尤其是儿科病例。一名患有自身免疫性甲状腺功能减退症的15岁女孩由于不坚持使用左甲状腺素药物而在2次单独出现无脉室性心律失常。随后的调查显示SCN5A突变与Brugada综合征相关。循环记录器捕获了多形性室性心动过速（PMVT），特别是TorsadesdePointes在她的第二个事件。只有在通过替代疗法稳定甲状腺激素水平后，才解决了两种心律失常。虽然罕见，甲状腺功能减退症患者可能出现室性心律失常，尤其是PMVT。甲状腺功能减退症引起的室性心律失常的治疗基石是甲状腺替代疗法。对明显甲状腺功能减退症所掩盖的SCN5A突变的鉴定强调，需要对甲状腺功能减退症患者进行全面的心脏评估，以评估其PMVT。
