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Thyrotoxic cardiac disease

Carolina Shalini Singarayar, Foo Siew Hui, Nicholas Cheong, Goay Swee En
Thyrotoxicosis is associated with cardiac dysfunction; more commonly, left ventricular dysfunction. However, in recent years, there have been more cases reported on right ventricular dysfunction, often associated with pulmonary hypertension in patients with thyrotoxicosis. Three cases of thyrotoxicosis associated with right ventricular dysfunction were presented. A total of 25 other cases of thyrotoxicosis associated with right ventricular dysfunction published from 1994 to 2017 were reviewed along with the present 3 cases...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Natalie Watson, Jane K Murray, Sonja Fonfara, Angie Hibbert
Objectives This study sought to explore the clinicopathological features and comorbidities of cats with mild, moderate and severe hyperthyroidism in a radioiodine referral population. Methods Medical records were reviewed, along with results of serum biochemistry, urinalysis, systolic blood pressure and diagnostic imaging performed at the time of radioiodine referral. Cats were grouped by total thyroxine (TT4) levels as mildly (TT4 60.1-124.9 nmol/l), moderately (TT4 125-250 nmol/l) or severely (TT4 >250 nmol/l) hyperthyroid at the time of diagnosis and referral...
February 1, 2018: Journal of Feline Medicine and Surgery
Keniel Pierre, Sushee Gadde, Bassam Omar, G Mustafa Awan, Christopher Malozzi
We report a 42-year-old female who was admitted for abdominal pain, and also endorsed dyspnea, fatigue and chronic palpitations. Past medical history included asthma, patent ductus arteriosus repaired in childhood and ill-defined thyroid disease. Physical examination revealed blood pressure of 136/88 mm Hg and heart rate of 149 beats per minute. Cardiovascular exam revealed an irregularly irregular rhythm, and pulmonary exam revealed mild expiratory wheezing. Abdomen was tender. Electrocardiogram revealed atrial fibrillation with rapid ventricular response which responded to intravenous diltiazem...
June 2017: Cardiology Research
Muhammad Ali Chaudhry, Siddharth Wayangankar
BACKGROUND: Thyrotoxic periodic paralysis (TPP) is a rare disease entity highlighted by hypokalemia, flaccid paralysis, and thyrotoxicosis. It usually presents as sudden profound muscle weakness manifested as almost complete immobility and can affect proximal and distal limb muscles, respiratory musculature as well as the cardiac conduction system. METHODS: A comprehensive review of Thyrotoxic periodic paralysis from 1885 to date was carried out by an extensive and thorough literature research including but not limited to Pubmed, Medline and EMBASE...
2016: Current Rheumatology Reviews
Osamah Hakami, Maswood M Ahmad, Naji Al Johani
Thyrotoxic periodic paralysis (TPP) is a potentially lethal complication of hyperthyroidism characterized by recurrent muscle weakness and hypokalemia. It has been commonly reported in non-Asian populations. Four cases were reported in Saudis so far, and one had a life-threatening arrhythmia. We describe an additional case of a 28-year-old apparently healthy Saudi male patient, who presented with acute paraparesis associated with hypokalemia (K: 2.0 mmol/L), complicated by ventricular tachycardia and cardiac arrest...
2016: Clinical Medicine Insights. Case Reports
Joseph Allencherril, Itamar Birnbaum
Thyrotoxicosis-induced cardiomyopathy and consequent heart failure is one of the most grave complications of uncontrolled hyperthyroidism. In such patients, early recognition of thyrotoxicosis, and directed antithyroid therapy can lead to rapid normalization of left ventricular function. Herein, we present a case of a 29-year-old male with Graves' disease who developed heart failure with severe deterioration of left ventricular function and eventually, circulatory collapse. Height and weight of the patient were 1...
December 2015: Journal of Extra-corporeal Technology
Mary Mickis, Tania Castleberry, Dian Dowling Evans
Thyrotoxic periodic paralysis is an uncommon thyroid emergency that is associated with electrolyte disturbances and a progressive flaccid paralysis of lower and upper extremities. Although not typically diagnosed within the emergency department setting, advanced practice registered nurses may be key in identifying this unusual condition where rapid and appropriate treatment precipitated by hyperthyroidism, most commonly resulting from Graves' disease can mitigate adverse cardiac, renal, and neurologic sequelae...
January 2016: Advanced Emergency Nursing Journal
Sri Harsha Tella, Anuhya Kommalapati
Thyrotoxic hypokalemic periodic paralysis (TPP) is a condition characterized by the triad of acute hypokalemia without total body potassium deficit, episodic muscle paralysis, and thyrotoxicosis. We describe two cases of thyrotoxic periodic paralysis who presented to our hospital with potassium values of 1.3 MeQ/l and 1.2 MeQ/l, respectively. Surprisingly, the two patients had no documented past medical history. Based on the clinical features of high heart rate, palpitations (seen in both the patients), and exophthalmos (seen in one patient), thyrotoxic periodic paralysis was suspected...
October 6, 2015: Curēus
M R Diaconescu, I Costea, M Glod, S Diaconescu
INTRODUCTION: The presence of striking cardiovascular manifestations were noted in the first descriptions of hyperthyroidism owing to Parry (1825) and Basedow (1840) in his famous Merseburg triad. Hyperthyroidism may either cause cardiac complications in individuals with a normal myocardium (genuine form of disorder) or complicate preexisting cardiac troubles. MATERIAL AND METHOD: An homogenous series of 49 cardiothyreosis, 11 males and 38 females, aged 12 - 78 (mean 45) years selected between 138 thyrotoxic patients operated on in a period of two decades is herein presented...
July 2015: Chirurgia
Andrew W Petersen, Gisela D Puig-Carrión, Angel López-Candales
Thyroid storm is a rare but potentially catastrophic disease expression of thyrotoxicosis with well-recognized cardiovascular manifestations such as heart failure and atrial fibrillation. Even through some studies have found an increased risk of cardiac thrombus formation and subsequent thromboembolism in these patients, the use of anticoagulation to prevent thromboembolic sequelae of thyrotoxic atrial fibrillation remains unclear. We present a patient presenting with new onset dilated cardiomyopathy and resistant atrial fibrillation with thyroid storm that had a large left atrial appendage clot...
January 2015: Boletín de la Asociación Médica de Puerto Rico
Raphael C Anakwue, Basden J Onwubere, Vincent Ikeh, Benedict Anisiuba, Samuel Ike, Angel-Mary C Anakwue
INTRODUCTION: Thyrotoxicosis is an endocrine disorder with prominent cardiovascular manifestations. Thyroid hormone acts through genomic and non-genomic mechanisms to regulate cardiac function. Echocardiography is a useful, non-invasive, easily accessible, and affordable tool for studying the structural and physiological function of the heart. AIM: We studied thyrotoxicosis patients in a Nigerian Teaching Hospital and employed trans-thoracic echocardiography to find out if there were abnormalities in the hearts of these patients...
2015: Therapeutics and Clinical Risk Management
Daniel Saenz-Abad, Elena Rivero-Sanz, Maria del Carmen Lahoz-Perez, Maria Martinez-Diez
Muscular weakness in young patients is usually due to mild, self-limiting causes. Nonetheless, it is important to remember other, more serious aetiologies which can cause this clinical picture. Thyrotoxic hypokalaemic periodic paralysis (THPP) is a rare disease in Europe and the USA, with fatal cardiovascular and respiratory complications. It is characterised by recurrent episodes of generalised muscular weakness, especially in the legs, with an associated hypokalaemia and hyperthyroidism. Diagnosis is based on clinical history, laboratory tests and an ECG...
March 3, 2014: BMJ Case Reports
Sibel Ertek, Arrigo F Cicero
Cardiovascular complications are important in hyperthyroidism because of their high frequency in clinical presentation and increased mortality and morbidity risk. The cause of hyperthyroidism, factors related to the patient, and the genetic basis for complications are associated with risk and the basic underlying mechanisms are important for treatment and management of the disease. Besides cellular effects, hyperthyroidism also causes hemodynamic changes, such as increased preload and contractility and decreased systemic vascular resistance causes increased cardiac output...
October 31, 2013: Archives of Medical Science: AMS
Thomas E Cope, Amal P R Samaraweera, David J Burn
BACKGROUND: Thyrotoxic periodic paralysis is rare in Caucasian populations, but affects approximately 2% of East Asians with thyrotoxicosis (13% of males, 0.17% of females). The presentation is characterized by abrupt-onset hypokalemia and profound proximal muscular weakness, and commonly occurs after carbohydrate loading or exercise. OBJECTIVES: To raise awareness of this condition through the description of a typical case of thyrotoxic periodic paralysis; to remind readers that, despite intravascular hypokalemia, total body potassium is normal and that correction must be done with caution; to highlight the differences in treatment compared to familial hypokalemic periodic paralysis...
September 2013: Journal of Emergency Medicine
Jane Hjørringgaard, Thomas Birkelund, Hanne Berg Ravn
A 52-year-old woman, who had an out-of-hospital cardiac arrest, was resuscitated, intubated and transferred with cardiogenic shock to angioplasty of the right coronary artery. Afterwards the patient had normal biventricular function, but four days later she developed atrial fibrillation and recurrent cardiogenic shock with a left ventricular ejection fraction of 20%. Thyrotoxic crisis was determined as the underlying cause; and antithyroid treatment stabilised the patient's haemodynamics completely within 24 hours...
April 1, 2013: Ugeskrift for Laeger
Dan Yun Chen, Peter F Schneider, Xiang Song Zhang, Zhi Min He, Tang Hua Chen
BACKGROUND: Thyrotoxic periodic paralysis (TPP) is a variant of periodic paralysis (PP) that occurs in patients with underlying mutations in genes for cation channels, if they develop thyrotoxicosis. It is disabling, and fatalities sometimes occur. Here, we present a patient with TPP who developed hypokalemic paralysis that was probably aggravated by the administration of a carbohydrate, probably contributing to, if not causing, a fatal outcome. SUMMARY: A 30-year-old Chinese patient received (131)I treatment for Graves' disease (GD) in our hospital...
September 2012: Thyroid: Official Journal of the American Thyroid Association
Jeisa Y Gómez-Torres, Wilfredo E Bravo-Llerena, Luis M Reyes-Ortiz, Rodrigo J Valderrábano-Wagner, Victor Mariano-Mejías, Héctor Brunet-Rodríguez, Juan C Lemos-Ramírez
We report a case of a 39 year-old Asian man in whom profound lower limb paralysis, along with severe hypokalemia and electrocardiographic changes, were the presenting features of Graves' disease (GD)-related thyrotoxicosis. Rapid recognition and management of the disorder were the key factors to avoid fatal hypokalemia-induced cardiac arrhythmias and promptly restore patient's capacity to ambulate.
April 2011: Boletín de la Asociación Médica de Puerto Rico
Subramanian Kannan, Joshua D Safer
OBJECTIVE: To review cardiac manifestations in the syndrome of resistance to thyroid hormone (RTH) and to question the general recommendation that the thyroid-stimulating hormone (TSH) value be the guide to thyroid hormone replacement. METHODS: The syndrome of RTH is caused by mutations in the carboxy-terminal portion of the β isoform of the thyroid hormone receptor, resulting in variable clinical manifestations. It is generally recommended that the replacement of thyroid hormone in patients with RTH be guided by the serum TSH concentration...
March 2012: Endocrine Practice
Preeti A Chandra, Ajay Vallakati, Abhinav B Chandra, Manali Pednekar, Joydeep Ghosh
Monomorphic ventricular tachycardia (VT) is a unique manifestation of hyperthyroidism. We present the case of a 41-year-old male with a history of hyperthyroidism presenting with palpitations secondary to non-sustained episodes of monomorphic VT. Cardiac arrhythmias due to thyrotoxicosis are perpetually supraventricular in origin. Monomorphic VT in the setting of thyrotoxicosis in the absence of structural heart disease is exceedingly rare. After starting propranolol and increasing the dose of methimazole, the patient had no further episodes of VT...
2010: American Heart Hospital Journal
Hee Jin Kim, Tae Sik Jung, Jong Ryeal Hahm, Seok-Jae Hwang, Sang Min Lee, Jung Hwa Jung, Soo Kyoung Kim, Soon Il Chung
BACKGROUND: Thyrotoxicosis influences cardiovascular hemodynamics and can induce coronary vasospasm. Patients with thyrotoxicosis-induced acute myocardial infarction (AMI) are unusual and almost all reported cases have been associated with Graves' disease. Patients with painless thyroiditis show a thyrotoxic phase during the early stages. Here we describe a very rare case of thyrotoxicosis with painless thyroiditis-induced AMI. SUMMARY: A 35-year-old Korean man visited the emergency room for a 2-hour duration of typical AMI chest pain...
October 2011: Thyroid: Official Journal of the American Thyroid Association
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