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t o r e g . c o m
Dr. Mete ALPASLAN
Hypothyroidism and ECG
The following ECG findings may be observed in patients with hypothyroidism
Sinus bradycardia
Low voltage
Prolongation of PR interval
Bundle branch blocks
T wave flattening or inversion
Ventricular premature contractions (VPC)
Sustained or non-sustained attacks of ventricular tachycardia (VT)
Prolonged QT interval
Increased dispersion of QT interval
Torsades de pointes
References
BMJ 2002;324:1320-3.
Am J Med Sci 2006;331:154-6.
ECG 1. The ECG above is from a 53 years-old hypothyroid woman with a TSH level of 18.
There is widespread T wave flattening .
Click here for a more detailed ECG
ECG 2a. The ECG above was recorded from a 44 years-old man with mitral stenosis.
The rhythm is atrial fibrillation with a high ventricular rate.
Click here for a more detailed ECG
ECG 2b. The ECG above belongs to the same man. It was recorded several months after the ECG 2a.
Now he has hypothyroidism and the TSH level is > 100 mIU/mL. This time, the rhythm is atrial fibrillation with a very low
ventricular rate. He is not taking beta blocker or calcium channel blocker.
Click here for a more detailed ECG
ECG 3. Ventricular bigeminal rhythm in the Holter recording of a 53 years-old woman with hypothyroidism.
Her TSH level is 18 mIU/mL.
Click here for a more detailed ECG
ECG 4a. The ECG above belongs to a 31 years-old woman with no apparent heart disease. She does not complain of any cardiac
symptoms. She was recently diagnosed as hypothyroidism (her TSH level is 43 mIU/mL). After recording of the above ECG,
she was referred to a cardiologist. Nonspecific T wave abnormality is seen in almost all leads.
Click here for a more detailed ECG
ECG 4b. The ECG above belongs to the same woman and was recorded one day after the ECG 4a. T wave flattening is seen in
almost all leads. This is a frequent ECG finding in patients with hypothyroidism. Absence of cardiac symptoms, the patient's
young age and failure to observe dynamic ECG changes (from ECG 4a to ECG 4b) further support the absence of coronary
artery disease.
Click here for a more detailed ECG
Sinus bradycardia
Low voltage
Prolongation of PR interval
Bundle branch blocks
T wave flattening or inversion
Ventricular premature contractions (VPC)
Sustained or non-sustained attacks of ventricular tachycardia (VT)
Prolonged QT interval
Increased dispersion of QT interval
Torsades de pointes
References
BMJ 2002;324:1320-3.
Am J Med Sci 2006;331:154-6.
ECG 1. The ECG above is from a 53 years-old hypothyroid woman with a TSH level of 18.
There is widespread T wave flattening .
Click here for a more detailed ECG
ECG 2a. The ECG above was recorded from a 44 years-old man with mitral stenosis.
The rhythm is atrial fibrillation with a high ventricular rate.
Click here for a more detailed ECG
ECG 2b. The ECG above belongs to the same man. It was recorded several months after the ECG 2a.
Now he has hypothyroidism and the TSH level is > 100 mIU/mL. This time, the rhythm is atrial fibrillation with a very low
ventricular rate. He is not taking beta blocker or calcium channel blocker.
Click here for a more detailed ECG
ECG 3. Ventricular bigeminal rhythm in the Holter recording of a 53 years-old woman with hypothyroidism.
Her TSH level is 18 mIU/mL.
Click here for a more detailed ECG
ECG 4a. The ECG above belongs to a 31 years-old woman with no apparent heart disease. She does not complain of any cardiac
symptoms. She was recently diagnosed as hypothyroidism (her TSH level is 43 mIU/mL). After recording of the above ECG,
she was referred to a cardiologist. Nonspecific T wave abnormality is seen in almost all leads.
Click here for a more detailed ECG
ECG 4b. The ECG above belongs to the same woman and was recorded one day after the ECG 4a. T wave flattening is seen in
almost all leads. This is a frequent ECG finding in patients with hypothyroidism. Absence of cardiac symptoms, the patient's
young age and failure to observe dynamic ECG changes (from ECG 4a to ECG 4b) further support the absence of coronary
artery disease.
Click here for a more detailed ECG