A Pacemaker that was Avoided

Waseem, Husnain; Hashmi, Arsalan Talib; Anser, Maham; Wali, Neehal; Rodríguez, Daniel; Greenberg, Yisachar

doi:10.7759/cureus.2555

Cited by 5 publications

(5 citation statements)

References 6 publications

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“… 2 Some scholars have reported an 87-year-old patient who developed high-grade atrioventricular block, which was successfully treated by supplementing thyroxine therapy and avoided the implantation of a pacemaker. 9 Schoenmakers et al reported an elderly patient with severe hypothyroidism and complete atrioventricular block, who was recovered after levothyroxine supplementation. 10 Our patient underwent intravenous temporary pacemaker because of severe bradycardia.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

Huang

Lei

et al. 2021

IMCRJ

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Background: Thyroxine is closely related to cardiovascular diseases, such as coronary heart disease, ventricular arrhythmia, atrioventricular block, myocardial systolic weakness, pericardial effusion, low cardiac output and hypertension. Previous studies have also found that hypothyroidism can also lead to mental disorders. Here, we present a rare case of severe hypothyroidism patient accompanied by sick sinus syndrome (SSS) as a cardiovascular manifestation needing cardiac pacing and severe mental disorders. Case Presentation: A 42-year-old female patient, previously healthy, was referred to our hospital because of bradycardia complicated with sick sinus syndrome which requiring cardiac pacing and severe mental disorders. Her clinical features along with laboratory findings strongly suggested that the patient had severe hypothyroidism with sick sinus syndrome and mental disorders, both of which were reversible and successfully treated with levothyroxine. Conclusion: This is the first reported case of hypothyroidism with sick sinus syndrome requiring pacemakers and psychiatric disorders, and the symptoms can be improved and reversed after thyroxine supplementation. This case highlights the importance of hypothyroidism screening when faced with unexplained psychosis or sick sinus syndrome, especially if combined.

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Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

Huang

Lei

et al. 2021

IMCRJ

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“…We conducted a literature review and found that there are few reported cases of cardiogenic shock and malignant arrhythmia caused by hypothyroidism, resulting in difficulties in the early identification and diagnosis. Previous reports of AVB caused by hypothyroidism have mainly been reported in adults (1)(2)(3)(4)(5), but rarely in children (8). Zaki (9) et al reported a case of refractory cardiogenic shock in an infant with congenital hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child

Zhang

Shao

et al. 2021

Front. Cardiovasc. Med.

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Background: Hypothyroidism can lead to bradycardia, reduced cardiac output, cardiac enlargement, and abnormal electrocardiogram. However, hemodynamic instability and malignant arrhythmias due to hypothyroidism is rarely reported in children.Patient Findings: We report the case of a child with third-degree atrioventricular block, cardiogenic shock, and Adams Stokes Syndrome, who was initially misdiagnosed with fulminant myocarditis and was later found to have hypothyroidism during treatment.Summary: The child's condition did not improve after the administration of gamma globulin, methylprednisolone, and isoproterenol. Even after the placement of temporary pacemakers, the therapeutic effect was still not ideal. Upon reviewing the medical history, the child's condition improved rapidly after levothyroxine supplementation.Conclusions: Hypothyroidism is a common disease, but secondary severe cardiovascular lesions are particularly rare in children. Therefore, the delay in diagnosis can lead to serious cardiovascular manifestations. When pediatric patients develop severe AVB and bradycardia, hypothyroidism should be considered as a possible cause.

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“…Harada et al reported a case of a myxedema coma in an elderly female pa-tient who presented with sick sinus syndrome and type two respiratory failure, which was successfully managed with thyroid hormone replacement (Harada et al, 2019). Also, Waseem et al (2018) reported a case of an elderly male with a history of undertreated hypothyroidism who presented with atrial fibrillation with a slow ventricular response as well as a high degree atrioventricular block. The atrioventricular block resolved upon increasing the dose of levothyroxine, thus avoiding the need for permanent pacemaker implantation (Lee et al, 1986).…”

Section: Discussionmentioning

confidence: 99%

Reversible bradycardia secondary to myxedema coma: case-report

Kousa

Mansour

Awad

et al. 2020

Reviews in Cardiovascular Medicine

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Myxedema coma occurs mostly in patients with longstanding untreated or undertreated hypothyroidism. Bradycardia is a well-known cardiac manifestation for myxedema coma; however, not all bradycardia with hypothyroidism are sinus bradycardia. Sick sinus syndrome is a group of arrhythmias caused by the malfunction of the natural pacemaker of the heart. Tachy-Brady syndrome is considered to be a type of sick sinus syndrome, where the heart alternates between tachycardia and bradycardia, and it is usually treated with pacemaker implantation along with rate slowing medical therapy. Here we report a case of an 83-year-old female who presented with myxedema coma and atrial fibrillation with tachycardia and intermittent slow ventricular response. We attempt to review the relationship between these two diseases and conclude that appropriate diagnosis of myxedema coma, may be beneficial in reducing the need for pacemaker implantation.

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A Pacemaker that was Avoided

Cited by 5 publications

References 6 publications

Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child

Reversible bradycardia secondary to myxedema coma: case-report

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