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Abstract The association between lack of thyroid hormones and cardiac dysfunction has been well described. We experienced a case of a 44-year-old woman with dilated cardiomyopathy (DCM) accompanied with long QT secondary to hypothyroidism and hypocalcaemia. Thyroid hormone acts on the myocardium of the heart and peripheral blood vessels. The genomic and non-genomic effects of thyroid hormone are associated with cardiovascular and chemodynamic function. A well documented but mostly overlooked sign in hypothyroidism is the prolongation of the QT interval. Long-QT syndrome, which is characterized by abnormal QT-interval prolongation on the surface ECG and an increased risk of sudden death, usually due to ventricular fibrillation. The mechanism of hypothyroidism on QT prolongation and the occurrence of ventricular tachycardia is unknown and the effect may be idiosyncratic, although coexistent.