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Hyperthyroid heart disease.
Clin Endocrinol Metab 1985; 14(2):491-508CE

Abstract

The importance of cardiovascular system involvement in hyperthyroidism has been recognized for many years. In the middle-aged and elderly patient, often with mild but prolonged elevation of plasma thyroid hormones, symptoms and signs of heart failure and complicating atrial fibrillation may dominate the clinical picture and mask the more classical endocrine manifestations of the disease. Pitfalls in diagnosis and the importance of early recognition and treatment are discussed. Despite experimental evidence for a short-term inotropic action of thyroid hormone excess, clinical data support the existence of a reversible cardiomyopathy in hyperthyroidism with impaired contractile reserve. Enhanced myocardial performance at rest primarily reflects the peripheral actions of thyroid hormone excess. Most, if not all, of the cardiac abnormalities return to normal once a euthyroid state has been achieved, although atrial fibrillation may persist in a minority. Optimum treatment requires rapid and definitive antithyroid therapy, usually using a large dose of radio-iodine, and rapid control of heart failure. Systemic anticoagulation is indicated in the presence of atrial fibrillation and should be continued until sinus rhythm has been present for at least three months, either spontaneously or after cardioversion.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2866053

Citation

Forfar, J C., and G C. Caldwell. "Hyperthyroid Heart Disease." Clinics in Endocrinology and Metabolism, vol. 14, no. 2, 1985, pp. 491-508.
Forfar JC, Caldwell GC. Hyperthyroid heart disease. Clin Endocrinol Metab. 1985;14(2):491-508.
Forfar, J. C., & Caldwell, G. C. (1985). Hyperthyroid heart disease. Clinics in Endocrinology and Metabolism, 14(2), pp. 491-508.
Forfar JC, Caldwell GC. Hyperthyroid Heart Disease. Clin Endocrinol Metab. 1985;14(2):491-508. PubMed PMID: 2866053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperthyroid heart disease. AU - Forfar,J C, AU - Caldwell,G C, PY - 1985/5/1/pubmed PY - 1985/5/1/medline PY - 1985/5/1/entrez SP - 491 EP - 508 JF - Clinics in endocrinology and metabolism JO - Clin Endocrinol Metab VL - 14 IS - 2 N2 - The importance of cardiovascular system involvement in hyperthyroidism has been recognized for many years. In the middle-aged and elderly patient, often with mild but prolonged elevation of plasma thyroid hormones, symptoms and signs of heart failure and complicating atrial fibrillation may dominate the clinical picture and mask the more classical endocrine manifestations of the disease. Pitfalls in diagnosis and the importance of early recognition and treatment are discussed. Despite experimental evidence for a short-term inotropic action of thyroid hormone excess, clinical data support the existence of a reversible cardiomyopathy in hyperthyroidism with impaired contractile reserve. Enhanced myocardial performance at rest primarily reflects the peripheral actions of thyroid hormone excess. Most, if not all, of the cardiac abnormalities return to normal once a euthyroid state has been achieved, although atrial fibrillation may persist in a minority. Optimum treatment requires rapid and definitive antithyroid therapy, usually using a large dose of radio-iodine, and rapid control of heart failure. Systemic anticoagulation is indicated in the presence of atrial fibrillation and should be continued until sinus rhythm has been present for at least three months, either spontaneously or after cardioversion. SN - 0300-595X UR - https://www.unboundmedicine.com/medline/citation/2866053/Hyperthyroid_heart_disease_ L2 - http://www.diseaseinfosearch.org/result/130 DB - PRIME DP - Unbound Medicine ER -