8th April 2024

A 34-year-old female freelance graphic designer with longstanding poorly controlled thyrotoxicosis

A 34-year-old female freelance graphic designer with longstanding poorly controlled thyrotoxicosis presents with shortness of breath, leg swelling and palpitations. She has struggled to take carbimazole as prescribed due to her busy lifestyle and has previously refused radio-iodine and thyroid surgery. Her HR is 110 bpm and her temperature is 38.2C. Her bloods show raised T3 and T4 with suppressed TSH. An echocardiogram shows an EF of 40%. What is the most likely underlying mechanism of heart failure in thyrotoxicosis?

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