Arterial Embolism in Thyrotoxicosis With Atrial Fibrillation

Bar-Sela, S; Ehrenfeld, Michael; Eliakim, M

doi:10.1001/archinte.1981.00340090087019

Cited by 112 publications

(43 citation statements)

References 12 publications

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“…She had a stroke, and her PT-INR was found to be only 1.14. Bar-Sela et al reported the incidence of atrial fibrillation in 142 patients with thyrotoxicosis to be 21%, while that of thromboembolic disease was 8.5%, and that cerebral emboli accounted for 53% of the episodes (18). This incidence is not very high, but this report shows that patients with thyrotoxicosis should be carefully monitored for thromboemboli.…”

Section: Discussionmentioning

confidence: 57%

Thyroid Storm with Multiple Organ Failure, Disseminated Intravascular Coagulation, and Stroke with a Normal Serum FT3 Level

et al. 2012

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Thyroid storm is a rare disorder with a sudden onset, rapid progression and high mortality. We experienced a case of thyroid storm which had a devastating course, including multiple organ failure (MOF), severe hypoglycemia, disseminated intravascular coagulation (DIC), and stroke. It was difficult to make a diagnosis of thyroid storm in the present patient, because she did not have a history of thyroid disease and her serum FT3 level was normal. Clinicians should be aware that thyroid storm can occur even when there is an almost normal level of thyroid hormones, and that intensive anticoagulation is required for patients with atrial fibrillation to prevent stroke after thyroid storm.

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Section: Discussionmentioning

confidence: 57%

Thyroid Storm with Multiple Organ Failure, Disseminated Intravascular Coagulation, and Stroke with a Normal Serum FT3 Level

et al. 2012

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“…A doença cerebrovascular isquêmica nos pacientes com hipertireoidismo costuma estar relacionada aos eventos cárdio-embólicos decorrentes da fibrilação atrial na tireotoxicose [31][32][33][34] , embora já tenham sido descritas algumas alterações vasculares intracranianas associadas à doença de Graves [35][36][37] . Quanto ao achado de tireotoxicose e dissecção carotídea bilateral em duas pacientes da nossa série, não encontramos referências específicas sobre essa possível relação.…”

Section: Discussionunclassified

Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes

Campos

Evaristo

Yamamoto

et al. 2004

Arq. Neuro-Psiquiatr.

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, Milberto Scaff 4 RESUMO -Objetivo: Dada a ausência de estudos de séries brasileiras de pacientes com dissecção arterial cervical espontânea, com o objetivo de descrever os fatores de risco, sintomas precedentes, manifestações clínicas, resultados da investigação, tratamento e evolução. Método: realizamos a análise retrospectiva dos prontuários e laudos radiológicos [angiografia digital(AD), ressonância magnética(RM) e ângio-ressonância(ARM)] dos pacientes com esse diagnóstico atendidos no Serviço de Neurologia do HC/USP entre 1997 e 2003. Resultados: 48 pacientes (24 homens), média de idade 37,9 anos; 26 pacientes com dissecção carotídea (DC) unilateral, 15 com vertebral (DV) unilateral e 7 com multiarterial, todos com déficits neurológicos. Os principais fatores de risco para doença vascular foram hipertensão arterial, tabagismo e dislipidemia. Mais de 80% apresentaram pelo menos um sintoma precedente, na maioria cefaléia têmporo-parietal. Cervicalgia foi referida por 44% dos pacientes com DV e por 3,4% dos com DC. O tempo médio entre o primeiro sintoma e o déficit foi 5,4 dias para as DC e 13,5 para as DV.AD foi o principal método diagnóstico (93%), associado a RM e ARM em 42% dos casos. Em 3 pacientes a RM cervical com supressão de gordura foi isoladamente suficiente. 75% dos pacientes receberam anticoagulação. Dois pacientes fizeram trombólise endovenosa sem complicações. A evolução foi boa, exceto por dois óbitos (DC bilateral). Conclusão: Os resultados são semelhantes aos da literatura, exceto pela baixa freqüência de cervicalgia nos casos de DC e pelo predomínio de cefaléia têmporo-parietal nas dissecções arteriais cervicais. Fatores de risco para doença vascular isquêmica foram frequentes. PALAVRAS-CHAVE: dissecção arterial, artéria carótida interna, artéria vertebral, angiografia, ressonância magnética. Spontaneous cervical carotid and vertebral arteries dissection -Study of 48 patientsABSTRACT -Objective: To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. Method: We performed the retrospective analysis of clinical and neuroradiological records (MRI, A-MRI and Angiography) of patients with this diagnosis who were evaluated in a tertiary hospital for the period of 1997-2003. Results: 48 patients (24 men) with median age 37.9 years: 26 patients with unilateral internal carotid dissection (ICAD), 15 with unilateral vertebral artery dissection (VAD) and 7 with multivessel dissections. All patients presented neurological deficits. Hypertension, smoking and dyslipidemia were the main risk factors. More than 80% of patients presented at least one initial symptom, most of them temporoparietal headache. 44% of patients with VAD and only 3.4% of patients with ICAD had neck pain. The median interval between the onset of symptom and the appearance of neurological deficit was 5.4 days for ICAD and 13.5 days for VAD. Five patients with ICAD presented preceding TIA. Angiography was performed in...

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“…Few studies have investigated the rate of peripheral embolism in patients with thyrotoxicosis complicated by AF. One such study investigated 142 subjects with thyrotoxicosis (Bar-Sela et al 1981). Twelve of 30 patients in AF had an embolic event (40%) compared with none in sinus rhythm (112 patients); the mean age of the patients in AF was significantly higher than those in sinus rhythm (56 vs 39 years).…”

Section: Thyroid Hormone and The Heartmentioning

confidence: 99%

Thyroid hormone in health and disease

Boelaert

Franklyn²

2005

Journal of Endocrinology

223

127

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Thyroid disease is common, affecting around 2% of women and 0·2% of men in the UK. Our understanding of the effects of thyroid hormones under physiological circumstances, as well as in pathological conditions, has increased dramatically during the last two centuries and it has become clear that overt thyroid dysfunction is associated with significant morbidity and mortality. Both hypoand hyperthyroidism and their treatments have been linked with increased risk from cardiovascular disease and the adverse effects of thyrotoxicosis in terms of osteoporosis risk are well established. Although the evidence suggests that successful treatment of overt thyroid dysfunction significantly improves overall survival, the issue of treating mild or subclinical hyper-and hypothyroidism remains controversial. Furthermore, the now wellestablished effects of thyroid hormones on neurodevelopment have sparked a whole new debate regarding the need to screen pregnant women for thyroid function abnormalities. This review describes the current evidence of the effects of thyroid hormone on the cardiovascular, skeletal and neurological systems, as well as the influence of thyroid diseases and their treatments on the development of malignancy. Furthermore we will describe some recent developments in our understanding of the relationship between thyroid status and health.

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Arterial Embolism in Thyrotoxicosis With Atrial Fibrillation

Cited by 112 publications

References 12 publications

Thyroid Storm with Multiple Organ Failure, Disseminated Intravascular Coagulation, and Stroke with a Normal Serum FT3 Level

Thyroid Storm with Multiple Organ Failure, Disseminated Intravascular Coagulation, and Stroke with a Normal Serum FT3 Level

Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes

Thyroid hormone in health and disease

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