Wolff-Parkinson-White syndrome associated with thyrotoxicosis∗

Sanghvi, L. M.; Banerjee, Kushal K.

doi:10.1016/0002-9149(61)90164-3

Cited by 8 publications

(3 citation statements)

References 16 publications

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“…Although in one of our three cases no murmur or abnormal sound was either heard or recorded from 1968 onwards, it would seem reasonable to suspect the presence of hypertrophic cardiomyopathy in addition to hyperthyroidism, should a mid or late systolic murmur persist after the euthyroid state is attained. Dysrhythmias commonly occur in both conditions, e.g., multiple ventricular ecoptic beats and atrial fibrillation, and although pre-excitation has been recorded in thyrotoxicosis (Sanghvi and Banerjee, 1961), it is not possible to state if either hypertrophic car-diomyopathy or thyrotoxicosis was the cause of this abnormality in our first patient. We have found echocardiography especially informative in screening patients with thyrotoxicosis as it is frequently impossible or undesirable to perform invasive investigations in these highly anxious subjects if hypertrophic myocardial disease is suspected.…”

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confidence: 75%

Hypertrophic cardiomyopathy and hyperthyroidism: a report of three cases

Symons

Richardson

Feizi

1974

Thorax

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0. (1974). Thorax, 29,[713][714][715][716][717][718][719] Hypertrophic cardiomyopathy and hyperthyroidism. The combination of hypertrophic cardiomyopathy and hyperthyroidism gives rise to a complex clinical picture as some of the symptoms and signs may be common to both conditions. The presentation and investigation of three patients are reported. In one patient there was evidence of progression from the hypertrophic obstructive phase to that associated with loss of outflow tract obstruction. The echocardiogram was especially useful in assessing the presence or absence of hypertrophic disease in the thyrotoxic subject. It is suggested that the long continued high-output circulatory state in clinically undetected hyperthyroidism may prove to be a stimulus for unrestrained cardiac muscle hypertrophy.Three patients are described, each of whom, at one time, had evidence of both hypertrophic cardiomyopathy and hyperthyroidism. Although the association of the two conditions may be fortuitous, the combination has not previously been reported, and the symptoms and signs pose problems in diagnosis which merit discussion. In addition, the extra work-load inherent in the maintenance of the hyperkinetic circulation in thyrotoxicosis might have some bearing on the aetiology of hypertrophic cardiomyopathy. Abnormal echocardiograms were recorded in each, and this technique proved a useful and simple method of screening these thyrotoxic patients when cardiomyopathy was suspected and prior to more detailed investigation by cardiac catheterization and angiography. CASE REPORTS PATIENT 1. A 38-year-old woman was referred to the cardiac clinic in 1958 because of a murmur. This had been noted by the general practitioner in 1956 but had not previously been commented upon at earlier routine examinations. Clinically an anxious woman of average build, the only physical abnormality was a grade 3/4 mid-to-late apical systolic murmur which ceased before the second sound. The blood pressure was 130/80 mmHg. The chest radiograph was normal. The electrocardiogram revealed sinus rhythm, frontal plane QRS axis -15°, a small Q in aVF, PR interval 0-12 sec. In 1959 she had attacks of paroxysmal supraventricular tachycardia, and a year later chest pain and shortness of breath on exertion occurred. In 1961 the electrocardiogram showed a pre-excitation type B pattern, PR interval 0-08 sec, frontal plane QRS axis +10°(repeated records remained almost identical henceforward). There was no alteration in the physical signs in the cardiovascular system but hyperthyroidism was suspected because of undue anxiety, tachycardia, and a small midline thyroid nodule. However, relevant investigations were negative (BMR 9%, 1'I thyroid uptake 25% at 4 hours and 50% at 48 hours).The patient was followed up routinely and in 1968 typical thyrotoxicosis developed, thyroid enlargement becoming more obvious, although there were no eye signs. The diagnosis was confirmed with thyroid function studies (protein-bound iodine 9-5 and 11 2 ,ug/ 100 ml, 13'I thyroid uptake 68 %...

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confidence: 75%

Hypertrophic cardiomyopathy and hyperthyroidism: a report of three cases

Symons

Richardson

Feizi

1974

Thorax

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“…Wolff Parkinson White syndrome (WPW) in cardiothyreosis is rarely reported in the literature. 24 In our series, only one patient had WPW syndrome (1%). Advanced age, pre-existing heart disease and the development of atrial fibrillation during hyperthyroidism are predictive factors for HF.…”

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confidence: 52%

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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“…53 54 55 Σύνδρομο Wölff-Parkinson-White 56 έκδηλα κύματα Τ, αύξηση του δυναμικού, μεταβολές στό διάστημα Q-T καί κοιλιακή ταχυκαρδία.…”

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Συστολικοι Χρονοι Σε Κολπικη Μαρμαρυγη Απο Υπερθυρεοειδισμο

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Wolff-Parkinson-White syndrome associated with thyrotoxicosis∗

Cited by 8 publications

References 16 publications

Hypertrophic cardiomyopathy and hyperthyroidism: a report of three cases

Hypertrophic cardiomyopathy and hyperthyroidism: a report of three cases

Cardiothyreosis: Epidemiological, clinical and therapeutic approach

Συστολικοι Χρονοι Σε Κολπικη Μαρμαρυγη Απο Υπερθυρεοειδισμο

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