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Apresenta-se um caso de toxicidade hepática induzida por produtos alternativos usados como terapêutica de emagrecimento. Discutem-se os mecanismos patogénicos da toxicidade e enfatizam-se os riscos decorrentes do consumo de substâncias pretensamente seguras mas suscetíveis de desencadear efeitos adversos potencialmente letais. Recebido: 25/05/2016 - Aceite: 01/08/2016

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Cardiovascular signs and symptoms can prevail in both hypothyroidism and hyperthyroidism. Case 1: 30-year-old female with acute right heart failure as first manifestation of Graves’ disease. It illustrates some of its cardiovascular complications, particularly pulmonary hypertension, tricuspid regurgitation, atrial fibrillation, mitral valve prolapse and mitral regurgitation. Case 2: 83-year-old-man with a severe primary hypothyroidism/ myxoedema crisis presented to emergency department with extreme bradyarrhythmia with hemodynamic impact and heart failure signs, which led to implantation of definitive pacemaker. Thyroid disorders are treatable entities and most cardiovascular changes are reversible. Early diagnosis is mandatory and can avoid severe complications and, eventually, invasive therapeutics interventions. Pulmonary hypertension and acute heart failure, especially in young adults, should be screened for underlying hyperthyroidism.