Table 7: Endocrine disorders associated with cardiomyopathies
| Syndrome: Acromegaly |
|---|
| Causes |
| Growth hormone and insulin-like growth factor 1 excess |
| Symptoms and signs |
| Tachycardia and hypertension, diabetes, rhythm disturbances Biventricular hypertrophy and diastolic dysfunction |
| Diagnosis |
| Nonsuppressibilty of serum growth hormone levels following glucose loading |
| Treatment |
| Surgery or pharmacotherapy may improve cardiovascular morbidity |
| Syndrome: Adrenal insufficiency (Addison's disease) |
|---|
| Causes |
| Lack of ACTH |
| Symptoms and signs |
| Hypotension, hypokalemia, syncope, bradycardia, prolonged QT, low voltage and heart failure |
| Diagnosis |
| Decrease response of the adrenal cortex to ACTH |
| Treatment |
| Replacement of the deficient steroid hydrocortisone |
| Syndrome: Cushing's disease |
|---|
| Causes |
| Excess production of glucocorticoids and androgens |
| Symptoms and signs |
| Hypertension, central obesity, proximal muscle weakness, myocardial infarction, stroke and cardiomyopathy |
| Diagnosis |
| Lack of appropriate suppression of cortisol secretion by dexamethasone |
| Treatment |
| Treat specific cause |
| Syndrome: Hypothyroidism (myxedema) |
|---|
| Causes |
| Low production of T3 and T4 |
| Symptoms and signs |
| Cardiac dilation, bradycardia, weak arterial pulses, angina, hypotension, distant heart sounds, low voltage and peripheral edema |
| Diagnosis |
| TSH, free T4 |
| Treatment |
| Hormone replacement |
| Syndrome: Hyperthyroidism |
|---|
| Causes |
| Excess production of T3 and T4 |
| Symptoms and signs |
| Tachycardia, wide pulse pressure, hyperkinetic cardiac apex, high CO heart failure |
| Diagnosis |
| TSH, free T4 |
| Treatment |
| Treat thyroid disease. Be careful with the use of beta-blockers |
| Syndrome: Pheochromocytoma |
|---|
| Causes |
| Catecholamine-producing tumour |
| Symptoms and signs |
| Hypertension 'paroxysmal', sweating, acute pulmonary edema, tachycardia, LVH, short PR interval, ST abnormalities, heart failure, myocarditis |
| Diagnosis |
| metanephrine levels |
| Treatment |
| Phenoxybenzamine hydrochloride, beta-blockers and surgery |