Diagnosis and management of the hypothyroid patient with chest pain

Pd, Myerowitz; Rw, Kamienski; Dk, Swanson; Ps, Chopra; Ha, Berkoff; Gm, Kroncke; Gg, Rowe; Cr, Vander Ark; Sp, Dhanani

doi:10.1016/s0022-5223(19)39209-8

Cited by 35 publications

(3 citation statements)

References 5 publications

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“…As retrospective and prospective studies of cardiac patients undergoing cardiac surgery or catheterization found no increase in the rate of adverse events in those patients whose hypothyroidism had not been treated, it is reasonable to proceed with the revascularization procedure before repleting thyroid hormone. [19], [20]…”

Section: Recommendations Pre-procedures Intervention For Subclinical ...mentioning

confidence: 99%

Pre-Procedure Intervention of Subclinical Hypothyroidism: Case Report

Tantri¹,

Syafril²

2023

JETROMI

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Background: Subclinical hypothyroidism (SH) is a very common disorder in the general population. In patients with known hypothyroidism or hypothyroidism who have been undergoing treatment, a TSH test should be included in the preoperative assessment to determine the adequacy of treatment and to ensure that thyroid therapy is optimized before surgery. Case Presentation: A 39 years old woman complains about a weakness that has been 4 years interfering with activities. Shortness of breath if doing strenuous activities, walking long distances, and climbing stairs, and shortness of breath decreases after rest. Sore throat found since 1 week of hospitalization, and fever for 1 day. A lump in the neck is not found. Previously, the patient had been treated for 8 days in the Department of Cardiology and planned the installation of a temporary pacemaker due to bradycardia that persisted until cardiac arrest. Conclusion: Subclinical hypothyroid patients undergoing pre-procedure intervention are predisposed to anemia, electrophysiologic disturbances, and hypotension, all of which can precipitate cardiovascular collapse. The goal of therapy in the perioperative patient with thyroid dysfunction centers around the attempt to normalize hormone levels before surgical intervention whenever possible and, when that is not feasible, to use other measures that will maximize hemodynamic stability and prevent decompensation.

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Section: Recommendations Pre-procedures Intervention For Subclinical ...mentioning

confidence: 99%

Pre-Procedure Intervention of Subclinical Hypothyroidism: Case Report

Tantri¹,

Syafril²

2023

JETROMI

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Section: P Erioperative M Anagement Of ...mentioning

confidence: 99%

Perioperative Management for Non-Thyroidal Surgery in Thyroid Dysfunction

Malhotra

Bhadada

2022

Indian Journal of Endocrinology and Metabolism

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Thyroid hormone exerts effects across all organ systems. Hence, patients with thyroid dysfunction are at a risk of numerous complications. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation, and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to optimize the status of thyrotoxic and hypothyroid patients. This article describes the adverse effects of thyroid dysfunction in patients undergoing nonthyroid surgery and recommends treatment approaches aimed at appropriate build-up to decrease perioperative risk.

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“…Although one may intuit from the above discussion that preoperative optimization of thyroid hormone status would benefit all patients, in cardiac patients with angina, there is a real possibility of worsening cardiac ischemia by replacing thyroid hormone and consequently increasing myocardial oxygen demand. In fact, as retrospective and prospective studies of cardiac patients undergoing cardiac surgery or catheterization found no increase in the rate of adverse events in those patients whose hypothyroidism had not been treated, 22 , 23 it is reasonable to proceed with the revascularization procedure before repleting thyroid hormone.…”

Section: Recommendations For Hypothyroid Patientsmentioning

confidence: 99%

Perioperative Management of Thyroid Dysfunction

Palace

2017

Health�Serv�Insights

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Due to the manifold effects of thyroid hormone across virtually all organ systems, the complications associated with thyroid dysfunction are numerous and diverse. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to be cognizant of the most effective means of optimizing the status of thyrotoxic and hypothyroid patients perioperatively. This article describes the adverse effects of thyroid dysfunction as they relate to the patient undergoing both thyroid and nonthyroid surgery and recommends treatment approaches aimed at decreasing perioperative risk.

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Diagnosis and management of the hypothyroid patient with chest pain

Cited by 35 publications

References 5 publications

Pre-Procedure Intervention of Subclinical Hypothyroidism: Case Report

Pre-Procedure Intervention of Subclinical Hypothyroidism: Case Report

Perioperative Management for Non-Thyroidal Surgery in Thyroid Dysfunction

Perioperative Management of Thyroid Dysfunction

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