Transient ST-Segment Elevation due to Iatrogenic Hyperthyroidism in a Patient with Normal Coronary Arteries

Mustafa, Çetìn; Özgül, Ülkü; Zehra, Güven Çetìn; Hülya, Çìçekçìoglu

doi:10.2169/internalmedicine.50.5099

Cited by 6 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Elderly patients without any pre-existing cardiac conditions may present with apathetic or subclinical hyperthyroid states, wherein the measurement of thyrotropin is indicated. Restoration of normal cardiac function is usually seen in such cases with therapy against thyrotoxicosis [33,[38][39][40][41].…”

Section: Thyrotoxicosis Heart Failure and Tachycardiomyopathymentioning

confidence: 99%

“…Moreover, T-wave inversion can be confused with effort angina in patients with thyrotoxic cardiomyopathy, and it might delay the identification of thyrotoxicosis as the causative etiology of cardiomyopathy and further worsen the prognosis [36][37][38]. Elevated free T4 (fT4) levels in the higher normal range might predispose to an increased risk of coronary artery disease in normal patients [37,[39][40][41].…”

Section: Thyrotoxicosis and Myocardial Ischemia With Ecg Changesmentioning

confidence: 99%

“…Amiodarone is one of the most commonly used broad-spectrum antiarrhythmics, containing approximately 37% iodine by weight, and is one of the medications recommended in the advanced cardiac life support (ACLS) protocol [41][42][43][44]. It is a class III antiarrhythmic used to control various atrial and ventricular arrhythmias of the heart with simultaneous class I, II, and IV effects [45].…”

Section: Thyrotoxicosis and Amiodaronementioning

confidence: 99%

See 2 more Smart Citations

Cardio-Thyrotoxicosis Syndrome: A Review of Thyrotoxic Cardiovascular Disease

Bhattad¹,

Roumia²

2023

Cureus

View full text Add to dashboard Cite

Thyrotoxicosis, an endocrine disorder characterized by elevated serum thyroid hormone levels of triiodothyronine (T3) and/or thyroxine (T4), can impact cardiovascular health in several ways. The cardiovascular system is often severely targeted by the thyrotoxic state, and the term "Cardio-thyrotoxic syndrome" has been proposed to encompass the various cardiovascular disease states resulting from thyrotoxicosis. In this review, we discuss various cardiovascular disorders resulting from the effects of thyrotoxicosis. It is important to keep a high index of suspicion for thyroid disorder in the setting of new atrial fibrillation, heart failure, and tachycardia-induced cardiomyopathy. Management of cardiothyrotoxicosis involves control of heart rate and blood pressure and treatment of acute cardiovascular complications. Thyroid-specific therapy to achieve a euthyroid state will not only improve but even potentially reverse cardiovascular abnormalities.

show abstract

Section: Thyrotoxicosis Heart Failure and Tachycardiomyopathymentioning

confidence: 99%

Section: Thyrotoxicosis and Myocardial Ischemia With Ecg Changesmentioning

confidence: 99%

Section: Thyrotoxicosis and Amiodaronementioning

confidence: 99%

See 1 more Smart Citation

Cardio-Thyrotoxicosis Syndrome: A Review of Thyrotoxic Cardiovascular Disease

Bhattad¹,

Roumia²

2023

Cureus

View full text Add to dashboard Cite

show abstract

“…The heartbeat time series in the VT/VF group came from patients with myocardial infarction (63.5%), CAD with no myocardial infarction (28.4%), dilated cardiomyopathy (18.9%), and sustained monomorphic VT (75%) attributed primarily to a chronic infarction scar. A myocardial scar from prior infarct is the most common cause of sustained monomorphic VT in patients with structural heart disease, whereas the most common cause of VF is acute coronary ischemia 83 . The stimulus-driven homeostatic HRV responder accurately resembled most of the HRV time series in the VT/VF group (Fig.…”

Section: Ventricular Tachycardia/ventricular Fibrillationmentioning

confidence: 99%

The control mechanisms of heart rate dynamics in a new heart rate nonlinear time series model

2020

Sci Rep

View full text Add to dashboard Cite

the control mechanisms of heart rate dynamics in a new heart rate nonlinear time series model Zonglu He the control mechanisms and implications of heart rate variability (HRV) under the sympathetic (SnS) and parasympathetic nervous system (pnS) modulation remain poorly understood. Here, we establish the HR model/HRV responder using a nonlinear process derived from newton's second law in stochastic self-restoring systems through dynamic analysis of physiological properties. We conduct model validation by testing, predictions, simulations, and sensitivity and time-scale analysis. We confirm that the outputs of the HRV responder can be accepted as the real data-generating process. Empirical studies show that the dynamic control mechanism of heart rate is a stable fixed point, rather than a strange attractor or transitions between a fixed point and a limit cycle; HR slope (amplitude) may depend on the ratio of cardiac disturbance or metabolic demand mean (standard deviation) to myocardial electrical resistance (PNS-SNS activity). For example, when metabolic demands remain unchanged, HR amplitude depends on PNS to SNS activity; when autonomic activity remains unchanged, HR amplitude during resting reflects basal metabolism. HR parameter alterations suggest that age-related decreased HRV, ultrareduced HRV in heart failure, and ultraelevated HRV in St segment alterations refer to age-related decreased basal metabolism, impaired myocardial metabolism, and SnS hyperactivity triggered by myocardial ischemia, respectively.Cardiac disturbances and PNS-SNS restoring force. Heart rate is determined intrinsically by the rate of spontaneous depolarization at the sinoatrial node, but is also modulated by both sympathetic and parasympathetic efferent innervation in response to cardiac disturbances (physical demands, stress, or hormonal factors) 39 . A cardiac disturbance can be driven by an excitatory event, an inhibitory event, or white noise. Excitatory events include acute stress such as low oxygen, high carbon dioxide, ischemia, or hypotension. Inhibitory events include acute stress such as hypertension or certain physiological states such as rest, sleep, comatose, or anesthetic state. Peripheral chemoreceptors located in the aorta, carotid arteries, and the brain are sensory extensions of the peripheral nervous system into blood vessels by which they detect changes in the concentrations of blood borne chemicals and afferent nerves carry them to the brainstem 40 . When baroreceptors located in the carotid sinus and in the aortic arch are excited by a stretch of the blood vessel, they sense the blood pressure changes and relay them to the lower brainstem. The SNS connected to the heart speeds up a slower-than-normal heartbeat by releasing neurohormones known as catecholamines (epinephrine and norepinephrine). The PNS located in the brainstem and upper or sacral portion of the spinal cord slows down a faster-than-normal heartbeat by releasing the neurohormone acetylcholine. The SNS and PNS exerts excitatory and inhibitory effect...

show abstract

“…10 Patients who experience AMI induced by thyrotoxicosis have an excellent prognosis. 10 Patients who experience AMI induced by thyrotoxicosis have an excellent prognosis.…”

mentioning

confidence: 99%