Title: Graves Disease Induced Dilated Cardiomyopathy

Authors: Mohammed Al-sadawi, MD, Hassan Alkhawam, MD, Timothy J Vittorio, MS, MD

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i9.15

Abstract

Gravis’ thyrotoxicosis is rarely complicated with heart failure. Here in, we present a case of 45 years old female without past medical history of cardiac disease who admitted to our hospital for altered mental status. Hospitalization course complicated with Atrial fibrillation with RVR and symptoms of acute heart failure. Subsequent echocardiogram revealed dilated cardiomyopathy. Labs were concerning about thyroid storm. Patient treated with Methimazole, steroids and Lugols iodine drops for thyroid storm and received appropriate management for heart failure. 

References

1.      Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. 1977.

2.      Siu CW, Yeung CY, Lau CP, Kung AW, Tse HF. Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism. Heart 2007 Apr ;93(4) ;483-7 Epub 2006 sep 27

3.      Frost L, Vestergaard P, MosekildeL.. Hyperthyroidism and risk of atrial fibrillation or flutter: a population based study. Arch. Intern.Med. 2004. Vol.164.1675–1678.

4.      Dörr M, Wolff B, Robinson DM, John U, Lüdemann J, Meng W, Felix SB, VölzkeH.. The association of thyroid function with cardiac mass and left ventricular hypertrophy. J Clin Endocrinol Metab. 2005; 90: 673–677.

5.      Rubin L. &Badesch D. Thyrotoxicosis as a Risk Factor for Pulmonary Arterial Hypertension. Ann Intern Med, February 7, 2006; 144(3): 222 - 223.

6.      Siu CW, Yeung CY, Lau CP, Kung AW, Tse HF. Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism. Heart 2007;93: 483-487.

7.      Book:  Lutton SR, Ratliff NB, Young JB, Cardiomyopathy and myocardial failure.

8.      Park KW, Dai HB, Ojamaa K, Lowenstein E, Klein I, Sellke FW: The direct vasomotor effect of thyroid hormones on rat skeletal muscle resistance arteries. AnesthAnalg1997;85:734–738

9.      Anthonisen P, Holst E, Thomsen A: Determination of cardiac output and other hemodynamic data in patients with hyper- and hypothyroidism, using dye dilution technique. Scand J Clin Lab Invest 1960;12:472–480

10.  DeGroot WJ, Leonard JJ: Hyperthyroidism as a high cardiac output state. Am Heart J 1970;79:265–275

11.  Soh M &Croxson M. Fatal thyrotoxic cardiomyopathy in a young man. BMJ. 2008; 337: a531

12.  Goldman LE, Sahlas DJ, Sami M. A case of thyrotoxicosis and reversible systolic cardiac dysfunction. Can J Cardiol 1999 Jul; 15(7);811-4

13.  Babenko A. Analysis of contribution of various factors in development and type of remodeling left ventricle at thyrotoxicosis. Bulletin of Almazov Federal Heart, Blood and Endocrinology Centre. – 2011. – N 2

14.  Geffner DL, Hershman JM. Beta-adrenergic blockade for the treatment of hyperthyroidism. Am J Med.1992;93:61–68. 

15.  Singh BN. Antiarrhythmic actions of amiodarone: a profile of a paradoxical agent. Am J Cardiol.1996;78:41–53. 

Corresponding Author

Mohammed Al-sadawi, MD

Saudi German Hospital – Madinah,

Madinah, Saudi Arabia

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