Journal List > Endocrinol Metab > v.26(3) > 1085893

Choi, Eom, Kim, Choi, Chung, and Lee: A Case of Ascites and Extensive Abdominal Distension Caused by Reversible Pulmonary Arterial Hypertension Associated with Graves' Disease


Patients with hyperthyroidism can develop left ventricular dysfunction and heart failure, but severe pulmonary hypertension association with hyperthyroidism is rarely seen. Herein, we describe the case of a 27-year-old female who presented with abdominal distension accompanied by pulmonary arterial hypertension and Graves' disease. Her pulmonary arterial hypertension was improved by treating the hyperthyroidism and pulmonary artery hypertension. Additionally, the patient's symptoms of right-side heart failure improved after pulmonary arterial pressure was reduced. Hyperthyroidism should be regarded as a reversible cause of associated pulmonary arterial hypertension.

Figures and Tables

Fig. 1
Abdominopelvic CT showed a large amount of peritoneal ascites and right pleural effusion.
Fig. 2
Echocardiography in 27-year-old woman with Graves' disease and severe pulmonary arterial hypertension. A. Right ventricle (RV) was markedly enlarged. Interventricular septum was flattened and left ventricle (LV) was got out of its shape into a 'D-shape'. B. The apical four-chamber view showed markedly enlarged right ventricle and right atrium. C. Doppler echocardiography showed moderate tricuspid regurgitation. D. A pressure gradient between the right ventricle and right atrium was 59.6 mmHg.
Fig. 3
Follow-up echocardiography after proper treatment of hyperthyroidism and pulmonary arterial hypertension. A. The D-shape of left ventricle (LV) was nearly disappeared. B. Peak systolic pulmonary artery pressure decreased from 74.6 mmHg to 49.39 mmHg. RV, right ventricle.


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