Hypothyroidism and Double Mitral Lesion in Antiphospholipid Syndrome During Pregnancy: A Case Report

BACKGROUND Antiphospholipid syndrome (APS) is an immune system disorder that causes an increased risk of blood clots and has been associated with the development of hypothyroidism and double mitral lesion, possibly due to immune complex deposition. This report describes a 34-year-old woman presenting with hypothyroidism and antiphospholipid syndrome with a double mitral lesion at 26 weeks of gestation. CASE REPORT We report the case of a 34-year-old woman with a history of hyperthyroidism that evolved into primary hypothyroidism, as well as APS under medical treatment, and fetal death during her first pregnancy. Subsequently, at 26 weeks of gestation in her second pregnancy, she presented a clinical picture of respiratory failure and precordial pain, which persisted with the same intensity and location despite postural changes for 2 days; after that, she had an increase in chest pain with irradiation to the front part of the chest, progressing to orthopnea. She was evaluated in the emergency room by Cardiology, where an echocardiogram was performed, which showed a double mitral lesion. The decision was made to admit her to intensive care with this diagnosis and pulmonary edema and establishing the specific treatment. She remained under obstetric surveillance and cardiovascular treatment until she was discharged. She maintained maternal-fetal stability cardiologic and endocrinological care, allowing the pregnancy to be successfully carried out to term without complications, and she and her baby showed very good perinatal results during the postpartum period. CONCLUSIONS This report highlights the importance of timely and accurate diagnosis of antiphospholipid syndrome and highlights the association with both hypothyroidism and double mitral lesion.