PULMONARY HYPERTENSION AND THYROID DISEASE

Abstract

P ulmonary arterial hypertension, regardless of its aetiology, is an extremely severe and life-threatening disease that is difficult to identify in its first stages because of the non-specific early symptoms.238 A high level of alertness to patients who are at risk, as well as the recognition of the early manifestations of the condition, are essential for prompt diagnosis, before significant and irreversible pathophysiological changes occur. The diagnostic approach, using an algorithm that includes various tests, is focused on ruling out other causes of pulmonary hypertension that are much more common and have a more favourable prognosis.239 Congenital hypothyroidism occurs in approxi-mately one in 4,000 deliveries. Although usually asymptomatic at birth, without adequate and early treatment it eventuates in substantial developmental delay. Due to the relative prevalence, severity of disease, and initially asymptomatic presentation, routine newborn screening has been instituted nationwide and accounts for the detection of the majority of congenitally hypothyroid neonates. Newborn screening for congenital hypothyroidism has greatly improved the outcome for the majority of infants with this disorder; treatment with adequate doses of L-thyroxine by 13 days of age usually results in normal psychomotor development compared to peers.240 The aim of this work is to study the association between congenital heart disease with secondary pulmonary hypertension (PH) and thyroid dysfunction. Our include patient group with pulmonary hypertension of various etiologies –as secondary to congenital heart disease referred for elective hemodynamic study- and a control group of the same age, sex, liability to Thyroid disease, selected from a list of patient seen in the pediatric clinic. during the period from june 2009- may 2011. This study was Case-control interventional study. All (cases and controls) were subjected to full history taking, thorough clinical examination with especial attention to anthropometric measures,Echocardiography, Doppler , High fidelity fluid filled catheters were used for hemodynamic measurements,and laboratory investigation as TSH T3 T4.