Thyroid hormone and myocardial ischaemia

Pantos, Constantinos; Mourouzis, Iordanis; Xinaris, Christodoulos; Cokkinos, Dennis V.

doi:10.1016/j.jsbmb.2008.03.011

Cited by 15 publications

(8 citation statements)

References 97 publications

(126 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We all fear the potential detrimental effects of thyroid hormone administration in a variety of clinical settings. Indeed, high doses of thyroxine can cause cardiac ischemia, even in the absence of significant coronary artery disease; increase oxygen demand, coronary spasm and arrhythmias (41). For this reason, levothyroxine is introduced in very small doses, in general, half of the 25 mcg tablet in patients with cardiovascular diseases.…”

Section: Drug Interaction and Concomitant Diseasesmentioning

confidence: 99%

The difficult patient: drug interaction and the influence of concomitant diseases on the treatment of hypothyroidism

Ward

2010

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

summaRyAlthough most hypothyroid patients do well with one single tablet of thyroxine daily, approximately 10% are dissatisfied and another important group of patients is difficult to control. We reviewed the most common causes for frequent-dose adjustment or high-dose requirement, including poor compliance with therapy and inadequate medication. Since these two causes have been ruled out, drug interaction and other concomitant diseases need to be investigated. Requirements of thyroxine increase in all conditions characterized by impaired gastric acid secretion. Proton-pump inhibitors, antacids and a long list of drugs may decrease thyroxine absorption. In addition, a series of diseases including celiac disease and chronic inflammatory intestinal diseases, as well as nutritional habits may be important in patient control. Finally, we mention the effects of a growing list of drugs and thyroid disruptors that may also affect thyroid hormone metabolism at many levels. Arq Bras Endocrinol Metab. 2010;54(5):435-42 Keywords Medication-taking behavior; compliance; bioequivalence; absorption; nutritional habits sumáRio Embora a maior parte dos pacientes com hipotiroidismo fique bem com um único comprimido diário de tiroxina, aproximadamente 10% não ficam satisfeitos e outro importante grupo de pacientes apresenta controle difícil. Foram revistas as causas mais comuns para necessidades frequentes de ajuste de dose ou uso de dose elevadas, incluindo falta de adesão à terapia e medicação inadequada. Descartando-se essas duas causas, é necessário investigar o uso de drogas e a presença de doenças concomitantes. Existe necessidade maior de tiroxina quando diminui a secreção ácida do estômago. Inibidores de bomba de prótons, antiácidos e uma longa lista de drogas podem dificultar a absorção da tiroxina. Várias doenças, incluindo a doença celíaca e as doenças intestinais inflamatórias crônicas, além dos hábitos alimentares, são importantes no controle do paciente hipotiroideo. Finalmente, foram mencionados os efeitos de uma lista crescente de drogas e disruptores que podem afetar o metabolismo tiroidiano em diferentes níveis. Arq Bras Endocrinol Metab. 2010;54(5):435-42 Descritores

show abstract

Section: Drug Interaction and Concomitant Diseasesmentioning

confidence: 99%

The difficult patient: drug interaction and the influence of concomitant diseases on the treatment of hypothyroidism

Ward

2010

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…23 Pre operatively thyroxin should be administered in a titrated manner to avoid higher levels before surgery as it may result in ischemia and infarction of Cardia due to increased demand by this tissue. 24 As an anesthetist point of view hypothyroidism may result in Cardiac suppression, hypoglycemia, impaired hepatic function, depressed ventilator drive and decreased plasma and blood volume. 22 Patients undergoing thyroid surgeries with profound Myxedema may land in Myxedema coma characterized by severe lethargy, hypothermia, Bradycardia and hypoxemia due to hypoventilation.…”

Section: Discussionmentioning

confidence: 99%

Role of Pre - Operative Investigations in Preventing the Post - Operative Complications of Thyroid Surgery

Reddy¹,

Ram²

2015

jemds

View full text Add to dashboard Cite

Thyroid surgeries are performed worldwide for various indications. In the past complications of thyroid surgeries were reported more than 24%. With an increase in accuracy in Cytological reporting, non-invasive radiological investigations to know the extent of the tumor and infiltration of malignant tumors, the complications are reduced to less than 4%. AIM: To evaluate the predictability of pre-operative investigations in preventing the post-operative complications of thyroid surgery. MATERIALS AND METHODS:A prospective study conducted on 86 patients by investigating before thyroid surgeries with FNAC, ultrasonography, CT scan, X-ray Neck lateral view, MRI, 2D ECHO of Cardia, isotope scanning, video laryngoscopy and thyroid function tests. Demographic characteristics of the patients and indications for thyroid surgeries were used to predict the postoperative complications. Post-operative investigations included serum calcium levels, Thyroid function tests and serum Electrolyte levels to diagnose the complications. RESULTS: sensitivity of FNAC was 93.33%, ultra sound Neck was 92.83%, serum calcium was 89.16%, in thyroid function tests it was 77.66%. With X-Ray Neck the specificity was 57.66%, CT scan was 44.50%, MRI was 15%, and isotope study was 30.6%, Doppler study was 33.83% and 2DEcho was 27.83%. Pre-operative assessment was Airway obstruction 3.48%, hematoma formation 4.65%, RLN palsy 3.48%, Hypocalcaemia 33.72%, wound infection 4.65% were the complications encountered. CONCLUSIONS: Thorough investigations prior to surgery of thyroid, proper selection of the surgical procedure, tumor location knowledge, understanding the pathophysiology of the thyroid disease and type of anesthesia gives confidence to the surgeon and avoids complications. The methods applied in the present study had a definitive role in preventing hypocalcaemia with an incidence of 33.72% and RLN palsy 3.48%. These were added upon by the experience of the operating surgeon.

show abstract

“…[14][15][16][17][18][19][20] Some investigators reported that mild hypothyroidism is associated with a significant increase of IHD risk only in middle aged (<65 yrs old) subjects, whereas mild thyroid failure may be harmless or beneficial in advanced age. 14,17 It has been suggested that at a y ounger age hypothyroidism may synergize (through dyslipidaemia, endothelial dysfunction or direct effect on the heart) with other genetic or environmental factors to increase the risk of IHD. On the other hand older subjects represent population with longer survival and lower cardiovascular risk, who might rather benefit from the energy sparing effects of mild hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Association of Age with Thyroid Hormone Status and Ischaemic Heart Disease (IHD)

Lovely

Begum²,

Akhter

et al. 2012

J Enam Med Col

View full text Add to dashboard Cite

Thyroid hormone and myocardial ischaemia

Cited by 15 publications

References 97 publications

The difficult patient: drug interaction and the influence of concomitant diseases on the treatment of hypothyroidism

The difficult patient: drug interaction and the influence of concomitant diseases on the treatment of hypothyroidism

Role of Pre - Operative Investigations in Preventing the Post - Operative Complications of Thyroid Surgery

Association of Age with Thyroid Hormone Status and Ischaemic Heart Disease (IHD)

Contact Info

Product

Resources

About