Graves’ Thyrotoxicosis-Induced Reversible Cardiomyopathy: A Case Report

Alghamdi, Ahmad; Aljohani, Naji

doi:10.4137/ccrep.s10534

Cited by 19 publications

(20 citation statements)

References 19 publications

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“…Definitive treatment with radioactive iodine ablation or thyroidectomy may also be considered to rapidly recover cardiac function [1]. Several studies have validated a reversal of echocardiographic abnormalities in these patients, once a euthyroid state has been established [1,46,47]. Additional treatment may include beta-adrenergic blockade to reduce heart rate, and diuretics to improve congestive symptoms [1].…”

Section: Discussionmentioning

confidence: 99%

Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure

et al. 2020

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The association between thyroid hormones and cardiovascular conditions has been well studied, specifically, the effects of hypothyroidism on cardiomyopathy, and hyperthyroidism with arrhythmias. Nonetheless, an explicit correlation between hyperthyroidism and cardiomyopathy has yet to be established. Medical databases MEDLINE and PubMed were accessed and queried as primary sources for data acquisition. Search criteria consisted of "hyperthyroidism", "heart failure", and "thyroid and cardiovascular system", which allowed the retrieval of relevant and recent works. From these sources, a consensus was developed and employed to yield an updated review of the etiology of heart failure in the setting of hyperthyroidism. It is rare for patients with hyperthyroidism to remain in a chronic hyperthyroid state, making it difficult to analyze subsequent long-term effects on the cardiovascular system. Related to heart failure, some studies have demonstrated no change in ejection fraction, while others have shown an acute change along with diastolic dysfunction, with or without an underlying rhythm abnormality. Further investigation is warranted to elucidate the mechanism driving such cardiac dysfunction, and whether it is due to vascular changes, tachyarrhythmias, or myocyte remodeling and fibrosis. The intent of this review article is to improve our understanding of how a hyperthyroid state affects cardiovascular function. An enhanced understanding of the effects on cardiovascular physiology will afford physicians the ability to provide more comprehensive care in consideration of both endocrine and cardiovascular pathologies.

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Section: Discussionmentioning

confidence: 99%

Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure

et al. 2020

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“…[7][8][9][10] The possible relationship between dilated cardiomyopathy, Takotsubo cardiomyopathy, and Graves' disease is reported in the literature. 11,12 Hübner et al experimentally revealed impairment of cardiac performance in both adolescent and adult mice with Graves' disease. The cardiac performance could be partly restored by early hormonal treatment, but adult mice lacked this recovery potential.…”

Section: Discussionmentioning

confidence: 99%

Changes in left ventricular function and contractile homogeneity in young adults with newly diagnosed hyperthyroidism due to Graves' disease

Zhou¹,

Tan²,

Lee

et al. 2019

J of Clinical Ultrasound

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Purpose The aim of this study was to investigate myocardial dysfunction and mechanical abnormalities in young patients with Graves' disease before therapy, using two‐dimensional speckle tracking echocardiography. Methods We performed a comprehensive transthoracic echocardiographic examination, including segmental and global radial strain, and time‐to‐peak radial strain, in 47 young patients with hyperthyroidism and 34 healthy adults. The time‐to‐peak radial strain was corrected by RR interval. The variables derived from radial myocardial deformation by the six‐basal, six‐mid, and six‐apical segmental model were compared to investigate the difference of the myocardial function between the two groups. Results Early diastolic mitral inflow velocity, E/A ratio, early diastolic mitral annular velocity, and e′/a′ ratio were lower in patients with Graves' disease than in controls. The left ventricular end‐diastolic volume, left ventricular end‐systolic volume, stroke volume, cardiac output, heart rate, late diastolic mitral inflow velocity, and late diastolic mitral annular velocity were slightly higher in patients than in controls. Radial strain, global radial strain, and corrected time‐to‐peak radial strain were lower in the patient group. Conclusions The decreased radial strain, global radial strain, and corrected time‐to‐peak radial strain in young patients with newly diagnosed hyperthyroidism due to Graves' disease could serve as an early sign of subclinical cardiac involvement.

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“…Unlike the other complications of GD, cardiomyopathy is life-threatening and therefore most of the patients who recover from cardiomyopathy are advised to undergo radioactive iodine ablation or thyroidectomy 3 4 5 6) . However, our patient did not undergo thyroidectomy or radioactive iodine ablation.…”

Section: Discussionmentioning

confidence: 99%

“…Although GD has been reported to cause DCMP in adults, the mechanism has not been documented precisely. There have been several reports of adults with DCMP due to GD, as well as of infants with congestive heart failure secondary to transient neonatal thyrotoxicosis 3 4 5 6) . Most of these patients are reported to have recovered completely after a euthyroid state was established, although a few of the adult patients died 5) .…”

Section: Introductionmentioning

confidence: 99%

Dilated cardiomyopathy with Graves disease in a young child

Choi

Jang

Park

et al. 2016

Ann Pediatr Endocrinol Metab

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Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP.

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Graves’ Thyrotoxicosis-Induced Reversible Cardiomyopathy: A Case Report

Cited by 19 publications

References 19 publications

Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure

Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure

Changes in left ventricular function and contractile homogeneity in young adults with newly diagnosed hyperthyroidism due to Graves' disease

Dilated cardiomyopathy with Graves disease in a young child

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