Reversible Thyrotoxic Cardiomyopathy: Prompt Resolution of Heart Failure in the Setting of Thyroid Storm (original) (raw)
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Reversible thyrotoxic cardiomyopathy: a case report
International Journal of Scientific Reports
Hyperthyroidism significantly affects the hemodynamics of the cardiovascular system. It is associated with development of atrial fibrillation, high output cardiac failure, pulmonary hypertension and dilated cardiomyopathy (DCM). In this paper we report a case of thyrotoxicosis induced cardiomyopathy. She was a 54 year old woman who presented with cardiomegaly (dilatation of all four chambers of the heart) secondary to Graves’ disease. She was treated with anti-thyroid drugs, β Blockers and diuretic and her euthyroid status was restored in 6 weeks. A repeat echocardiogram done at this point of time showed normal cardiac function with normalization of ejection fraction. So this was a case of reversible thyrotoxic cardiomyopathy.
Thyroid Storm-induced Severe Dilated Cardiomyopathy and Ventricular Tachycardia
Cureus, 2019
Thyroid storm is an extreme form of hyperthyroidism associated with a high mortality rate. Heart failure is considered the leading cause of mortality in patients with thyroid storm, though the underlying cardiac pathology is unclear. Approximately 6% of patients with thyroid storm have heart failure symptoms as the initial presenting complaint. Roughly, one-third of these patients develop dilated cardiomyopathy (DCM). In this report, we present a case of cardiogenic pulmonary edema and sustained ventricular tachycardia in a patient with hyperthyroidism presenting with thyroid storm.
Thyrotoxic Cardiomyopathy: State of the Art
European Endocrinology
Thyroid hormones, mainly triiodothyronine, have genomic and non-genomic effects on cardiomyocytes related to the contractile function of the heart. Thyrotoxicosis, which is the set of signs and symptoms derived from the excess of circulating thyroid hormones, leads to increased cardiac output and decreased systemic vascular resistance, increasing the volume of circulating blood and causing systolic hypertension. In addition, the shortening of the refractory period of cardiomyocytes produces sinus tachycardia and atrial fibrillation. This leads to heart failure. Approximately 1% of patients with thyrotoxicosis develop thyrotoxic cardiomyopathy, a rare but potentially fatal form of dilated cardiomyopathy. Thyrotoxic cardiomyopathy represents a diagnosis of exclusion, and prompt identification is crucial as it is a reversible cause of heart failure, and heart function can be recovered after achieving a euthyroid state using antithyroid drugs. Radioactive iodine therapy and surgery are ...
High-output congestive heart failure: a potentially deadly complication of thyroid storm
Oxford Medical Case Reports, 2019
Hyperthyroidism, thyrotoxicosis and thyroid storm are a continuum of disease. A life-threatening and potentially fatal manifestation of thyrotoxicosis is thyroid storm. Thyroid storm is considered rare with an occurrence rate of 1-2% of all patients with hyperthyroidism, making a high index of suspicion important in the early recognition of this debilitating complication. We present the case of a 63-year-old female with a significant history of being non-compliant with her hyperthyroidism regimen and presented to the emergency department in severe respiratory distress. She was ultimately diagnosed with thyroid storm induced high-output congestive heart failure, intubated, had a cardiac arrest and was transferred to the intensive care unit in a guarded condition. Her hospital course was unremarkable and she was discharged on Day 12.
Determinants of Thyrotoxic Cardiomyopathy Recovery
BioMed Research International, 2013
The purpose was to evaluate the effect of the disease duration prior to treatment, thyroid hormones level, or both on the reversibility of dilated cardiomyopathy. Between January 2006 and December 2010, a longitudinal study with a 6 months follow-up was carried on. One hundred and seventy patients with hyperthyroidism were referred to the cardiologist, and 127 had a 6 months followup after antithyroid treatment and were evaluated by echocardiography. Dilated cardiomyopathy reversibility criteria were established according to echocardiographic parameters. Complete reversibility existed when all parameters were met, partial reversibility when LVEF was ≥55% plus two or three other parameters, and no reversibility when LVEF was ≤55% regardless of other parameters. The results showed that echocardiography parameters related to the regression of myocardial mass were associated with a disease duration shorter than 10.38 months. This was the main predictive variable for reversal of dilated cardiomyopathy, followed byblocker treatment, and the last predictive variable was the serum level of free triiodothyronine. This study showed that the effect on the myocardium related to thyrotoxicosis was associated with the disease duration before treatment.
Acute Thyrotoxicosis Induced Reversible Cardiomyopathy in an Adult Patient
Hamidiye Medical Journal, 2021
Çoğu olgularda, konjestif kalp yetmezliği (KKY) genellikle koroner arter hastalığına veya kalp kapak hastalığına ikincil olarak gelişir. Bununla birlikte, akut tirotoksikoz, bazı hastalarda KKY'nin seyrek bir nedeni olabilir. Bu olguda, daha önce kronik hastalık tanısı olmayan, KKY ve yeni gelişen atriyal fibrilasyon ile acil servise başvuran erişkin bir hastayı sunduk. Ek olarak, bu olguda, akut tirotoksikozun nispeten genç bireylerde ciddi ancak geri dönüşlü sol ventrikül disfonksiyonuna neden olabileceğini gösterdik.
Graves’ Thyrotoxicosis-Induced Reversible Cardiomyopathy: A Case Report
Clinical Medicine Insights: Case Reports, 2013
The objective of this report is to present a case of Graves’ thyrotoxicosis-induced cardiomyopathy. This is a case of a 26 year old woman that presented with severe symptomatic congestive heart failure and was subsequently diagnosed with dilated cardiomyopathy secondary to Graves’ disease. Despite an initial left ventricular systolic ejection fraction of 20% on echocardiography, treatment with anti-thyroid agents led to rapid improvement of her clinical status and normalization of her ejection fraction. The proposed mechanisms underlying the development of systolic dysfunction in thyrotoxicosis are discussed and the literature on similar cases previously reported is highlighted. Cardiomyopathy should be considered even in young patients with Graves’ thyrotoxicosis.
Current Heart Failure Reports, 2008
The most recognizable features of hyperthyroidism are those that result from the effects of triiodothyronine (T 3 ) on the heart and cardiovascular system: decreased systemic vascular resistance and increased resting heart rate, left ventricular contractility, blood volume, and cardiac output. Although these measures of cardiac performance are enhanced in hyperthyroidism, the fi nding of clinical cardiac failure can be somewhat paradoxical. About 6% of thyrotoxic individuals develop symptoms of heart failure, but less than 1% develop dilated cardiomyopathy with impaired left ventricular systolic function. Heart failure resulting from thyrotoxicosis is due to a tachycardia-mediated mechanism leading to an increased level of cytosolic calcium during diastole with reduced ventricular contractility and diastolic dysfunction, often with tricuspid regurgitation. Pulmonary artery hypertension in thyrotoxicosis is gaining awareness as a cause of isolated right-sided heart failure. In both cases, older individuals are more likely to be affected. Treatment needs to be directed at management of the acute cardiovascular complications, control of the heart rate, and thyroid-specifi c therapy to restore a euthyroid state that will lead to resolution of the signs and symptoms of heart failure.
Cardiorespiratory Failure in Thyroid Storm: Case Report and Literature Review
Journal of clinical medicine research, 2018
Thyroid storm is a potentially fatal manifestation of thyrotoxicosis. Cardiopulmonary failure is the most common cause of death in thyroid storm. Clinicians should keep in mind that thyroid storm complicated with cardiopulmonary failure can be the first presentation of thyrotoxicosis. As early intervention is associated with improved patient outcome, prompt diagnosis based on clinical grounds is of paramount importance in the management of thyrotoxicosis. A high index of suspicion and the ability of early recognition of impending thyroid storm depends on a thorough knowledge of both the typical and atypical clinical features of this illness. Herein, we report a case of thyroid storm presenting as cardiopulmonary failure in a 51-year-old woman with undiagnosed Grave's disease. Additionally, we review the pathophysiology of cardiopulmonary failure associated with thyrotoxicosis and various treatment modalities for thyroid storm.