Hyperthyroid heart disease in pregnancy: Retrospective analysis of a case series and review of the literature

Table 1 Clinical characteristics of six pregnant patients with hyperthyroid heart disease

Demographic	Vital signs at admission	Cardiac evaluation at admission	Complications and aggravating factors	NYHA
26 yr G5P1+3 (31 + 4 wk)	T 36.5 °C, HR 153 bpm, BP 141/78 mmHg, R 32 breaths/min, SpO2 85%; Vaginal examination revealed blood-stained mucus and a dilated cervix of 1 cm	Echocardiography: Enlarged left atrium and ventricle (LA 31 mm, LV 46 mm); EF 25%. Thoracic ultrasound: Bilateral pleural effusion, left 3.5 cm right 3.0 cm	Scarred uterus, stillbirth	IV
24 yr G2P0+1 (35 + 1 wk)	T 36.6 °C, HR 110 bpm, BP 168/98 mmHg, R 30 breaths/min, SpO2 89%	Echocardiography: Enlarged left atrium and ventricle (LA 44 mm, LV 58 mm); moderate mitral regurgitation (Vmax 4.0 m/S); EF 53%. Chest radiography: Cardiomegaly and mild bilateral pleural effusion; patchy consolidation in low lobes of lung of both sides; Cardiothoracic ratio 0.61	Preeclampsia, pulmonary infection, anaemia	IV
30 yr G2P1 (34 + 4 wk)	T 37.4 °C, HR 130 bpm, BP126/80 mmHg, R 35 breaths/min, SpO2 94%	Echocardiography: Enlarged left atrium and ventricle (LA 39 mm, LV 51 mm); grossly mitral regurgitation (Vmax 5.3 m/S); EF 50%. Chest radiography: Cardiomegaly and mild bilateral pleural effusion; cardiothoracic ratio 0.59. Thoracic ultrasound: Bilateral pleural effusion, left 0.8 cm right 2.9 cm	Anaemia, pulmonary infection	IV
29 yr G3P1+1 (30 + 4w)	T 38.3 °C, HR 130 bpm, BP 138/80 mmHg, R 40 breaths/min, SpO2 88%	Echocardiography: Enlarged left atrium (LA 40 mm); moderate mitral regurgitation (Vmax 5.6m/S); EF 62%	Chorioamnionitis?	III
24 G4P1+2 (38 + 6 wk)	T 36.3 °C, HR 100 bpm, BP 113/70 mmHg, R 25 breaths/min, SpO2 95%	Echocardiography: Normal, EF 59%. 24 hours dynamic electrocardiogram: normal	Scarred uterus, pulmonary infection	III
27 yr G1P0 (38 + 6 wk)	T 36.5 °C, HR 80 bpm, BP 102/60 mmHg, R 25 breaths/min, SpO2 97%	Echocardiography: Enlarged left atrium and ventricle (LA 39 mm, LV 62 mm); EF 37%. 24-hour dynamic electrocardiogram: Premature ventricular contractions	Pulmonary infection	III

BP: Blood pressure; EF: Ejection fraction; HR: Heart rate; LA: Left atrium; LV: Left ventricle; LVEF: Left ventricular ejection fraction; NYHA: New York Heart Association; R: Respiratory rate; SpO₂: Oxygen saturation while breathing air; T: Temperature.