Thyrotoxic pericarditis: An underappreciated phenomenon

Gupta, Puneet; Chhabra, Lovely; Hiendlmayr, Brett; Spodick, David H.

doi:10.1016/j.ijcard.2015.06.130

Cited by 11 publications

(23 citation statements)

References 10 publications

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“…Compared with patients with pericarditis associated with hypothyroidism, there is less incidence and severity of pericardial effusion. 36-40…”

Section: Hyperthyroidism-induced Pericarditismentioning

confidence: 99%

“…Compared with patients with pericarditis associated with hypothyroidism, there is less incidence and severity of pericardial effusion. [36][37][38][39][40] As with hypothyroidism, the treatment of hyperthyroidism is paramount toward complete resolution of pericarditis. Pharmacotherapy used to treat hyperthyroidism can be considered in select patients-those who are not candidates for thyroidectomy or radioactive iodine therapy.…”

Section: Hyperthyroidism-induced Pericarditismentioning

confidence: 99%

“…Pharmacotherapies to treat hyperthyroidism-induced pericarditis consist of colchicine, ASA/NSAIDs, and/or corticosteroids therapy. [35][36][37][38][39][40][41] The use of pharmacotherapies to treat the pericarditis should be balanced with managing the treatment of the cardiac manifestations of hyperthyroidism as well as the use of pharmacotherapy to treat the hyperthyroidism in certain patient populations. Although patients with acute IP are usually treated for 3 months with colchicine, clinicians could consider using colchicine until TSH/ free thyroid hormone levels are within normal range.…”

Section: Hyperthyroidism-induced Pericarditismentioning

confidence: 99%

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Pharmacotherapeutic Management Strategies for Thyroid Disease–Induced Pericarditis

Schwier

O’Neal

2019

Ann Pharmacother

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Objective: To describe the various pharmacotherapeutic strategies in managing thyroid disease-induced pericarditis (TDIP). Considerations for both hypothyroid-induced and hyperthyroid-induced pericarditis will be discussed. Data Sources: A literature search of MEDLINE, including PubMed, was performed inclusive of all years, using the following search terms: thyroid disease, pericardial diseases, pericarditis, acute pericarditis, cholesterol pericarditis, hypothyroidism, hyperthyroidism, colchicine, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, methimazole, propylthiouracil, and P-glycoprotein. Product monographs were reviewed as well. Study Selection and Data Extraction: Relevant English-language studies and data as well as the most current guidelines for diagnosis and management of thyroid and pericardial diseases were considered. Because of limited data regarding the subject matter, no date range limits were established during literature search. Data Synthesis: It is well documented that thyroid dysfunction can adversely affect cardiovascular function. Additionally, there are published guidelines on the diagnosis and management of pericarditis and, separately, thyroid disease. There are limited data, however, on managing TDIP. The sequela of untreated TDIP can be detrimental. Relevance to Patient Care and Clinical Practice: Strategies on managing TDIP are scarcely reported in the literature. This review provides clinicians with a single reference source for treatment strategies toward managing hypothyroidism-induced and hyperthyroidism-induced pericarditis as well as significant drug interactions that can potentially confound the management of hypothyroidism- and hyperthyroidism-induced pericarditis. Conclusions: Treatment of TDIP involves addressing both the thyroid disease as well as the pericarditis. Along with treatment strategies, clinicians should also consider potential drug-drug and drug-disease interactions that can potentially worsen clinical outcomes.

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“…Compared with patients with pericarditis associated with hypothyroidism, there is less incidence and severity of pericardial effusion. 36-40…”

Section: Hyperthyroidism-induced Pericarditismentioning

confidence: 99%

Section: Hyperthyroidism-induced Pericarditismentioning

confidence: 99%

Section: Hyperthyroidism-induced Pericarditismentioning

confidence: 99%

See 1 more Smart Citation

Pharmacotherapeutic Management Strategies for Thyroid Disease–Induced Pericarditis

Schwier

O’Neal

2019

Ann Pharmacother

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“…Hyperthyroidism causes a variety of cardiovascular effects, including tachycardia, arrhythmias, high output cardiac failure, and hypertension. 1 However, the association between pericarditis or myocarditis and thyrotoxicosis is rare, with only a handful of case reports described. 1–6 The cardiovascular effects of hyperthyroidism are thought to be mediated by the actions of triiodothyronine on nuclear receptors in cardiomyocytes, leading to altered expression of genes involved in intracellular calcium homeostasis and in turn to increased chronotropy and inotropy.…”

Section: Introductionmentioning

confidence: 99%

“… 1 However, the association between pericarditis or myocarditis and thyrotoxicosis is rare, with only a handful of case reports described. 1–6 The cardiovascular effects of hyperthyroidism are thought to be mediated by the actions of triiodothyronine on nuclear receptors in cardiomyocytes, leading to altered expression of genes involved in intracellular calcium homeostasis and in turn to increased chronotropy and inotropy. The mechanisms by which hyperthyroidism may lead to pericarditis and myocarditis are less well characterized.…”

Section: Introductionmentioning

confidence: 99%

Myopericarditis and thyroiditis: a case report

Thomson

Rossberg

Davar

et al. 2021

European Heart Journal - Case Reports

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Background Hyperthyroidism is commonly associated with adverse cardiovascular effects, including tachydysrhythmia, heart failure, and hypertension, although the association between hyperthyroidism and myopericarditis is restricted to a small number of case reports. Case summary A 45-year-old Caucasian male with no past medical history was admitted with chest pain. The electrocardiogram demonstrated diffuse ST-segment elevation, the troponin T rose, and he was diagnosed with myopericarditis. He was noted to have markedly deranged thyroid function tests and a diagnosis of hyperthyroidism secondary to Graves’ disease was made. He was treated with Bisoprolol, Carbimazole, Prednisolone, Ibuprofen, and Colchicine, his symptoms resolved rapidly and he was discharged. Five weeks later he re-presented with similar symptoms and recurrent pericarditis was diagnosed. His symptoms settled with a repeat course of steroids. Discussion We hypothesize that there may be an underappreciated link between hyperthyroidism and myopericarditis. Potential pathophysiological mechanisms include viral infection, autoimmunity, or changes in myocardial fat metabolism. Suggested management consists of a combination of current guidelines for the treatment of hyperthyroidism and pericardial disease, with attention to certain disease–drug interactions. Further research is required to evaluate the true incidence of hyperthyroidism-associated myopericarditis, elucidate its pathophysiology and instruct management.

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