Atrioventricular block in patients with thyroid dysfunction: Prognosis after treatment with hormone supplementation or antithyroid medication

Özcan, Kazım Serhan; Osmonov, Damirbek; Erdinler, İzzet; Altay, Servet; Yıldırım, Ersin; Türkkan, Ceyhan; Hasdemir, Hakan; Çakmak, Nazmiye; Alper, Ahmet Taha; Satılmış, Seçkin; Gürkan, Kadir

doi:10.1016/j.jjcc.2012.05.012

Cited by 37 publications

(26 citation statements)

References 20 publications

(23 reference statements)

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“…16 In other studies, AV block was explained by a different factor such as electrolyte imbalance (hypercalcaemia, hypokalaemia), infection, or digoxin administration. [17][18][19][20][21][22] There is a wide spectrum of potential aetiologies of complete AV block, 23 but in our case clear triggering factor other than thyrotoxicosis was not detected. Mildly abnormal laboratory results were not able to explain AV block.…”

Section: Discussionmentioning

confidence: 70%

Third degree atrioventricular block as a rare complication of Graves' thyrotoxicosis

Širanec¹,

Magage²,

Válek³

et al. 2019

Cor Vasa

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Kompletní atrioventrikulární (AV) blokáda představuje vzácnou, avšak život ohrožující komplikaci tyreotoxikózy. V literatuře bylo dosud popsáno pouze několik případů s nejistou kauzální souvislostí s hypertyroidním stavem. Vzhledem k nedostatku údajů nepanuje absolutní shoda ohledně reverzibility této abnormality AV převodu, a tedy i nutnosti implantace trvalého kardiostimulátoru. V naší kazuistice popisujeme případ 35leté pacientky, u které se nově diagnostikovaná Gravesova-Basedowova tyreotoxikóza poprvé manifestovala synkopou při kompletní AV blokádě. V úvodu hospitalizace došlo ke spontánní obnově AV převodu v poměru 1 : 1, což vedlo k výrazné sinusové tachykardii s frekvencí 150/min, která byla symptomatická bolestmi na hrudi, prekolapsovým stavem a vedla k rozvoji srdečního selhání v důsledku hyperkinetické cirkulace. Další komplikací byla epizoda asystolie při recidivě úplné AV blokády bez náhradního rytmu s nutností dvouminutové kardiopulmonální resuscitace a emergentní dočasné transvenózní kardiostimulace. Při léčbě tyreostatiky a kortikosteroidy se po 48 hodinách stabilizoval srdeční rytmus se sklonem k sinusové tachykardii. Další průběh byl již nekomplikovaný, včetně dobré tolerance léčby beta-blokátorem. Komplexní vyšetření (včetně magnetické rezonance srdce) neprokázalo žádnou jinou příčinu vysvětlující kompletní AV blokádu. Zvažovanou implantaci trvalého kardiostimulátoru pacientka odmítla. V následujících třech měsících sledování již nebyla recidiva AV blokády zaznamenána.

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Section: Discussionmentioning

confidence: 70%

Third degree atrioventricular block as a rare complication of Graves' thyrotoxicosis

Širanec¹,

Magage²,

Válek³

et al. 2019

Cor Vasa

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“…Myxedema coma requiring temporary or permanent pacemaker implantation is rare, and the requirement of the procedure is mainly due to second‐degree or complete AV block. Although those conditions usually need permanent pacemaker insertion even after normalization of thyroid status, reversible cases have been reported . To cite an example, Waseem et al reported a case of myxedema coma with severe bradycardia and high‐grade AV block that was successfully treated with thyroxine hormone replacement without requiring cardiac pacemaker placement .…”

Section: Discussionmentioning

confidence: 99%

Myxedema coma accompanied by sick sinus syndrome and hypoventilation: A case report

Harada

Murakami

Tokumasu

et al. 2019

J of Gen and Family Med

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Myxedema coma is an emergency presentation of hypothyroidism, and cardiopulmonary manifestations of the disease are related to a high mortality rate. We herein report a case of myxedema coma accompanied by sick sinus syndrome requiring temporary cardiac pacing and hypercapnic respiratory failure in an 87‐year‐old woman. This case is unique because both of the cardiac and pulmonary manifestations were reversible and successfully treated with thyroid hormone replacement. Our case indicates that early detection of the condition and administration of levothyroxine are essential to improve the life‐threatening condition and avoid invasive treatment such as permanent pacemaker implantation or intubation.

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“…Coexistent infection, hypercalcaemia and concurrent drug use have also been implicated as contributory factors to AV block in these patients 3. Beta-adrenoceptor antagonists, which form standard treatment for symptomatic tachycardia in paediatric hyperthyroidism,4 block sympathetic stimulation to both the sinoatrial and AV nodes.…”

Section: Discussionmentioning

confidence: 99%

Atrioventricular block: an unusual complication of Graves’ disease

Adesokan¹,

Vigneswaran

Ajzensztejn

et al. 2017

BMJ Case Reports

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We report the case of a 10-year-old girl treated with atenolol and carbimazole for tachycardia and hypertension associated with Graves' disease who developed symptomatic 2:1 heart block. 2:1 heart block resolved following cessation of atenolol, reduction in carbimazole dose and treatment of suspected tonsillitis. First-degree atrioventricular block persisted, but gradually normalised following improvement in thyroid status.

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Atrioventricular block in patients with thyroid dysfunction: Prognosis after treatment with hormone supplementation or antithyroid medication

Abstract: AV block associated with thyroid dysfunction needs great attention regardless of type of the thyroid disease. Patients with II and/or III degree AV block in the setting of thyroid dysfunction almost always need permanent pacemaker insertion even after normalization of thyroid status.

Cited by 37 publications

References 20 publications

Third degree atrioventricular block as a rare complication of Graves' thyrotoxicosis

Third degree atrioventricular block as a rare complication of Graves' thyrotoxicosis

Myxedema coma accompanied by sick sinus syndrome and hypoventilation: A case report

Atrioventricular block: an unusual complication of Graves’ disease

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