Thyrotoxic Cardiomyopathy

Yu., A. Blednova; Alekber, A.; Elena, N Parovichnikova; Eugenia, O.

doi:10.5772/29331

Cited by 3 publications

(7 citation statements)

References 74 publications

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“…Mrad et al 11 found that increased FT4 levels were predictive of heart failure. However, other studies 3,15,16 had found that the intensity of biological hyperthyroidism (with FT4>3 times normal) was associated with a lower risk of cardiothyreosis. In our series, the mean TSH level was 0.042 µIU/ml and FT4 was 59.6 pmol/l.…”

Section: Discussionmentioning

confidence: 91%

Cardiothyreosis: Epidemiological, clinical and therapeutic approach

Elleuch

Molka

Sawssan

et al. 2023

Clin Med Insights Cardiol

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Introduction: Cardiothyreosis corresponds to the cellular effects of free thyroid hormones on the vascular wall and the myocardium. We aim to describe the clinical, para-clinical and therapeutic aspects of cardiothyreosis and to detail prognostic factors. Methods: We conducted a descriptive retrospective study at the Endocrinology-Diabetology Department of the Hedi Chaker University Hospital in Sfax-Tunisia. We collected medical records of 100 patients with cardiothyreosis between January 1999 and December 2019. We included patients with cardiothyreosis who underwent adequate cardiac evaluation. We excluded patients with cardiac abnormalities related to conditions other than hyperthyroidism, patients who died and patients without cardiothyreosis. Results: We included 100 adult patients (43 men and 57 women). The mean age was 49.3 ±12.9 years (20-79 years). The diagnosis of cardiothyreosis was concomitant with that of hyperthyroidism in 72% of cases. Weight loss and palpitations were the two most frequently reported signs in 91% of cases each. Hypertension was systolic in 15 patients. The average heart rate was 103.1 beats/min (52-182 bpm). The mean TSH and FT4 levels were 0.042 μIU/ml and 59.6 pmol/l, respectively. Rhythm disorders and heart failure were the most common cardiac complications with 81 and 56 cases, respectively. Cardiac ultrasound showed dilatation of the left atrium in 28.3% of patients. Pulmonary arterial hypertension was present in 43% of cases. 57 patients had been treated with benzylthiouracil at a mean dose of 157.45 mg/day. Radical treatment with radioactive iodine was indicated in 81 patients. The evolution of cardiothyreosis was favourable in 58 patients. Conclusion: Cardiothyreosis is a serious complication of hyperthyroidism. Future prospective studies will be of great help to better characterise and manage cardiothyreosis.

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Section: Discussionmentioning

confidence: 91%

Cardiothyreosis: Epidemiological, clinical and therapeutic approach

Elleuch

Molka

Sawssan

et al. 2023

Clin Med Insights Cardiol

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“…As there are more β-adrenergic receptors on the surface of atrial cardiac myocytes, atrial sensitivity to thyroid hormones is greater. 26 For this reason, the frequency of atrial fibrillation and supraventricular extrasystoles is higher than in the general population, but the frequency of ventricular arrhythmias is similar. Similarly, androgens increase the expression of β-adrenergic receptor genes.…”

Section: Pathophysiologymentioning

confidence: 99%

“…The most frequently reported arrhythmia is sinus tachycardia (42–73%), followed by atrial fibrillation (9–23%). 26 , 33 Other less frequent types include extrasystoles (5–7%), atrioventricular block (2.7–5%), atrial flutter (1.2–2.3%) and paroxysmal supraventricular tachycardia (0.2–3.3%). 26 In some cases, patients with hyperthyroidism undergoing treatment report chest pain associated with electrocardiographic changes, such as alterations in the ST segment and the T wave, simulating myocardial ischaemia, and advanced stages of TCM with signs of volume overload can be observed.…”

Section: Diagnosismentioning

confidence: 99%

“… 26 , 33 Other less frequent types include extrasystoles (5–7%), atrioventricular block (2.7–5%), atrial flutter (1.2–2.3%) and paroxysmal supraventricular tachycardia (0.2–3.3%). 26 In some cases, patients with hyperthyroidism undergoing treatment report chest pain associated with electrocardiographic changes, such as alterations in the ST segment and the T wave, simulating myocardial ischaemia, and advanced stages of TCM with signs of volume overload can be observed. 33 The findings described in the electrocardiogram are not specific; however, they are useful to raise suspicion of TCM, and are usually reversible after reaching a euthyroid state.…”

Section: Diagnosismentioning

confidence: 99%

“… 43 Therefore, signs of diastolic dysfunction are common, such as increased end-diastolic volume and left ventricular hypertrophy, prolonged isovolumic relaxation time (greater than 90 ms) and E-wave deceleration time (greater than 210 ms). 26 …”

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Thyrotoxic Cardiomyopathy: State of the Art

Quiroz-Aldave¹,

Durand-Vásquez²,

Lobato-Jeri³

et al. 2023

European Endocrinology

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Thyroid hormones, mainly triiodothyronine, have genomic and non-genomic effects on cardiomyocytes related to the contractile function of the heart. Thyrotoxicosis, which is the set of signs and symptoms derived from the excess of circulating thyroid hormones, leads to increased cardiac output and decreased systemic vascular resistance, increasing the volume of circulating blood and causing systolic hypertension. In addition, the shortening of the refractory period of cardiomyocytes produces sinus tachycardia and atrial fibrillation. This leads to heart failure. Approximately 1% of patients with thyrotoxicosis develop thyrotoxic cardiomyopathy, a rare but potentially fatal form of dilated cardiomyopathy. Thyrotoxic cardiomyopathy represents a diagnosis of exclusion, and prompt identification is crucial as it is a reversible cause of heart failure, and heart function can be recovered after achieving a euthyroid state using antithyroid drugs. Radioactive iodine therapy and surgery are not the best initial therapeutic approach. Moreover, it is important to manage cardiovascular symptoms, for which beta blockers are the first-line therapeutic option.

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Cardiac Arrest as First Presentation of Thyroid Storm

Zayour¹,

Yasmin²,

Baydoun³

et al. 2023

Cureus

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Thyroid storm is a life-threatening condition characterized by a high level of circulating thyroid hormones and harbors high mortality and morbidity, even if diagnosed and treated early. The condition is frequently overlooked and under-recognized in emergency departments owing to its rarity. Here, we present a case of a 24-year-old male patient, previously healthy, who presented with cardiac arrest and was found to have heart failure and high thyroid hormone levels after investigations. Consequently, the presentation was attributed to thyroid storm. His clinical status and cardiac function improved after treatment of the hyperthyroidism.

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Thyrotoxic Cardiomyopathy

Cited by 3 publications

References 74 publications

Cardiothyreosis: Epidemiological, clinical and therapeutic approach

Cardiothyreosis: Epidemiological, clinical and therapeutic approach

Thyrotoxic Cardiomyopathy: State of the Art

Cardiac Arrest as First Presentation of Thyroid Storm

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