Prävention und multimodale Therapie der Hyperthyreose

Abstract

Subclinical and overt hyperthyroidism have been associated with various negative clinical outcomes as for example an increased risk of atrial fibrillation or increased cardiovascular mortality, especially in old age. In order to avoid hyperthyroidism it is strongly recommended not to start any iodine containing drug therapy or to avoid application of contrast agents unless the patient presents with an unremarkable clinical course. TSH suppressive therapy for the treatment of endemic goiter or differentiated low risk thyroid carcinoma is unnecessary, since it favours the development of subclinical hyperthyroidism. Overt hyperthyroidism is treated with antithyroid drugs and/or radioiodine therapy or surgery according to the underlying disease (toxic nodular goiter, Graves' disease).

State of the art paper Hyperthyroidism and cardiovascular complications: a narrative review on the basis of pathophysiology

“…Since the first descriptions of hyperthyroidism and thyrotoxicosis, the cardiovascular symptoms have been alarming signs for the physician in the clinical presentation of the patient. Palpitations, exercise intolerance, dyspnoea, angina-like chest pain, peripheral oedema and congestive heart failure are common symptoms of hyperthyroidism [ 1 , 2 ] that could show cardiovascular involvement of this relatively frequent endocrinological disorder. Although effects of iodization and world-wide use of radiocontrast agents may change the incidence, overt hyperthyroidism is common and affects 2–5% of the population [ 3 , 4 ].…”

Study on Heart Measurements of the People between the age 20-40 Years Present to the Teaching Hospital Colombo North – Post mortem Study

“…Fisher's exact test was used to calculate the P value. 30.0-34.9 0(0) 0(0) 0(0) 50( 1) 50(1) 2 20( 1) 20(1) 0(0) 05 30-34.9 0(0) 0(0) 0(0) 0(0) 50( 1) 50 (1) 02 Cont... Table 4 Variation of heart weight in females and males according to the BMI Majority of the males had the left ventricular thickness of 1.4cm (53%) and females had the left ventricular thickness of 1.3cm (37%). But the p value was 0.3667 (>0.05) hence there was no significant association between the gender and different left ventricular thickness.…”

“…[18,19,20,21,22,23,2425,26,27,29,30,31,3 6, 40,41,42,43] • Died while being managed for poisoning/drugs that has direct effects on heart. [14,17,20] • Cadavers with cardiac pathology detected at autopsy • Cadavers with changes of decomposition • Diseased died of Sepsis or septicemia • Cadavers of trained athletes and hard working manual workers. (28) • Pregnancy or post partum deaths.…”

Study on Heart Measurements of the People between the Age 20-40 Years Present to the Teaching Hospital Colombo North – Post Mortem Study

“…[18,19,20,21,22,23,2425,26,27,29,30,31,3 6,40,41,42,43] • Died while being managed for poisoning/drugs that has direct effects on heart. [14,17,20] • Cadavers with cardiac pathology detected atautopsy • Cadavers with changes ofdecomposition • Diseased died of Sepsis orsepticemia • Cadavers of trained athletes and hard working manualworkers. (28) • Pregnancy or post partumdeaths.…”