A 44-year-old woman comes to the office for annual follow-up. She has no other medical conditions rather than hypothyroidism due to chronic autoimmune (Hashimoto) thyroiditis. She feels well and has no palpitations, heat/cold intolerance, diarrhea/constipation, or changes in weight. The patient takes levothyroxine daily on an empty stomach. Her vital signs are within normal range. BMI is 26 kg/m². On physical examination, the thyroid is normal to palpation. There is no peripheral edema. Laboratory results show a serum TSH level of

Question

A 44-year-old woman comes to the office for annual follow-up. She has no other medical conditions rather than hypothyroidism due to chronic autoimmune (Hashimoto) thyroiditis. She feels well and has no palpitations, heat/cold intolerance, diarrhea/constipation, or changes in weight. The patient takes levothyroxine daily on an empty stomach. Her vital signs are within normal range. BMI is 26 kg/m². On physical examination, the thyroid is normal to palpation. There is no peripheral edema. Laboratory results show a serum TSH level of <0.01 µU/mL. She has a concern regarding maintaining the current dose of levothyroxine, this would put this patient at the greatest risk for which of the following complications?

Quizplus · Accepted Answer

Eductional Objective: Thyrotoxicosis, whether due to endogenous hyperthyroidism or over-replacement with thyroid hormone in patients with hypothyroidism, causes a hyperadrenergic state that can lead to atrial fibrillation, high-output heart failure, and worsening of angina pectoris.

A 44-Year-Old Woman Comes to the Office for Annual Follow-Up