This is the first case to report coexisting Marfan syndrome and hyperthyroidism, two recognized contributory factors of dilated cardiomyopathy, in a patient who presents with rapidly progressive severe congestive cardiac failure. Dilated cardiomyopathy was the first presenting feature in this young tall man with Marfanoid phenotype who had only a few vague symptoms of hyperthyroidism. Initial cardiac failure treatment with optimised medical therapy did not show improvement and even led to rapid deterioration in the presence of undiagnosed hyperthyroidism which rapidly progressed to thyroid storm. Full screening for all possible underlying causes of dilated cardiomyopathy should be recommended even the patient has full-blown phenotypic pictures of Marfan syndrome, a recognized cause of dilated cardiomyopathy. The weakness in connective tissue integrity in Marfan syndrome can be a vulnerable factor for severe and rapidly progressive cardiomyopathy if the patient has coexisting dilated cardiomyopathy secondary to hyperthyroidism.
Manuscripts that are Published Ahead of Print have been peer reviewed and accepted for publication by the Editorial Board of the West Indian Medical Journal. They may appear in their original format and may not be copy edited or formatted in the style guide of this Journal. While accepted manuscripts are not yet assigned a volume, issue or page numbers, they can be cited using the DOI and date of e-publication. See our Instructions for Authors on how to properly cite manuscripts at this stage. The contents of the manuscript may change before it is published in its final form. Manuscripts in this section will be removed once they have been issued to a volume and issue, but will still retain the DOI and date of e-publication.