Heart failure as a serious complication of iodinated contrast-induced hyperthyroidism: case-report

Abstract

Background exposure to iodinated contrast media (ICM) can cause hyperthyroidism, due to disruption of thyroid hormone regulation. Although rare, it can have severe consequences and can lead to fatal complications. Current guidelines do not recommend standard laboratory testing of the thyroid function prior to ICM exposure. Prophylactic treatment of patients at higher risk of hyperthyroidism is not advised. Case presentation we report the case of an 82-year-old woman who developed ICM induced hyperthyroidism after undergoing a chest computed tomography (CT). One month after ICM administration she presented with pneumonia at the emergency department. Hyperthyroidism was found with concomitant tachycardia, which was hard to control. As a result of hyperthyroidism and coincidental pneumonia the patient developed heart failure and died of myocardial ischemia. Conclusions this case report underlines the importance of close monitoring of high-risk patients after ICM exposure. Clinicians should be aware of the risk of hyperthyroidism and potential severe complications. The use of ICM needs careful consideration, especially in the elderly who suffer more often from multinodular goitre.

Risk of Major Cardiovascular Disease after Exposure to Contrast Media: A Nationwide Population-Based Cohort Study on Dialysis Patients

“…In a laser argon-induced thrombosis model in mesenteric microvessels, Iopamidol and iohexol demonstrated prothrombotic properties by inducing a significant rise in the number of emboli and the duration of embolization [ 14 ]. Exposure to ICM can exacerbate hyperthyroidism in elderly patients with underlying thyroid disease, and that can lead to serious heart failure complication secondary to ischemic events [ 15 ]. However, previous CIM-related cardiovascular studies had limited case numbers, and the long-term effects of intravenous ICM-CT exposure on the cardiovascular system in the dialysis population have not been well studied.…”

Computed tomography requisitions among children and young adults in sub-Saharan Africa: are we doing it right?

“…This is a pending radiation safety disaster for Africa given that, 75% of the population is 35 years and below, with a median age of 15.8 years. Apart from the risks of radiation induced damages and cancers, inappropriate CT procedures wastes the already strained imaging resources, exposes patients to invasive diagnostic procedures, increases waiting time for treatment, overcrowding of CT units, risks of contrast media induced complications for patients to mention but a few [13,14].…”