PMC8230540_01
The ECG and chest radiograph of the patient before thyroxine supplementation (A-D). Follow-up with cardiologist and endocrinologist for repeat ECG in 4 weeks (E,F).
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F1
AVB with a minimum heart rate of 75 beats/min (on isoproterenol therapy) (Figures 1A,B). Echocardiography excluded other abnormalities (such as coronary artery disease, congenital heart disease, and cardiomyopathy) showing normal size of ventricle and atrium, normal left ventricular systolic function with an ejection fraction (EF) of 57% and a fractional shortening (FS) of 30%. A chest radiograph showed mild pulmonary edema, enlarged heart shadow, heart-to-chest ratio of 0.57, and intestinal dilatation with gas accumulation (Figures 1C,D). On the eighth day of admission, the patient was discharged on levothyroxine 50 mug daily and was advised to follow-up with cardiologist and endocrinologist for repeat thyroid function testing and ECG in 4 weeks (Figures 1E,F).