Abstract
The cases of two patients with hyperthyroidism and acute left ventricular (LV) dysfunction with segmental wall motion abnormalities resulting in heart failure are reported. Both had electrocardiographic changes mimicking ischemic coronary artery disease. Treatment with antithyroid medications, beta blockers, and angiotensin‐converting enzyme inhibitors rapidly restored LV function. The rapid reversibility suggests a role for myocardial stunning, an important entity to recognize in hyperthyroidism since this form of LV dysfunction can be reversed with appropriate treatment.
Keywords: hyperthyroidism, left ventricular dysfunction, myocardial stunning
Full Text
The Full Text of this article is available as a PDF (366.2 KB).
References
- 1. Skelton LC: The heart and hyperthyroidism. N Engl J Med 1982; 307 (19): 1206–1207 [DOI] [PubMed] [Google Scholar]
- 2. Woeber KA: Thyrotoxicosis and the heart. N Engl J Med 1992; 327: 94–98 [DOI] [PubMed] [Google Scholar]
- 3. Forfar JC, Muir AL, Sawers SA, Toft AD: Abnormal left ventricular function in hyperthyroidism: Evidence for a possible reversible cardiomyopathy. N Engl J Med 1982; 307: 1165–1170 [DOI] [PubMed] [Google Scholar]
- 4. Umpierrez GE, Challapali S, Patterson C: Congestive heart failure due to reversible cardiomyopathy in patients with hyperthyroidism. Am J Med Sci 1995; 310 (3): 99–102 [DOI] [PubMed] [Google Scholar]
- 5. Ebisawa K, Ikeda U, Murata M, Sekiguchi H, Nagai R, Yazaki Y, Shimada K: Irreversible cardiomyopathy due to thyrotoxicosis. Cardiology 1994; 84: 274–277 [DOI] [PubMed] [Google Scholar]
- 6. Somerville W, Levine SA: Angina pectoris and thyrotoxicosis. Br Heart J 1950; 12: 245–247 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7. Masani ND, Northridge DB, Hall RJC: Severe coronary vasospasm associated with hyperthyroidism causing myocardial infarction. Br Heart J 1995; 74: 700–701 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. Moliterno D, Debold CR, Robertson RN: Case report: Coronary vasospasm‐relation to the hyperthyroid state. Am J Med Sci 1992; 304: 38–42 [DOI] [PubMed] [Google Scholar]
- 9. Wei JY, Genecin A, Greene HL, Achuff SC: Coronary spasm with ventricular fibrillation during thyrotoxicosis: Response to attaining euthyroid state. Am J Cardiol 1979; 43: 335–339 [DOI] [PubMed] [Google Scholar]
- 10. Bell MR, Lapeyre AC, Bove AA: Angiographic demonstration of spontaneous diffuse three vessel coronary artery spasm. J Am Coll Cardiol 1989; 14: 523–527 [DOI] [PubMed] [Google Scholar]
- 11. Marti V, Ballester M, Obrador D, Moya C, Carrio I, Pons‐Llado G: Active myocardial damage in hyperthyroidism. A concurrent mechanism of heart failure reversed by treatment. Eur Heart J 1995; 16 (7): 1014–1016 [DOI] [PubMed] [Google Scholar]
- 12. Wood R, Commerford PJ, Rose AG, Tooke A: Reversible catechol‐amine‐induced cardiomyopathy. Am Heart J 1991; 121: 610–613 [DOI] [PubMed] [Google Scholar]
- 13. Pavin D, Breton HL, Daubert C: Human stress cardiomyopathy mimicking acute myocardial syndrome. Heart 1997; 78: 509–511 [DOI] [PMC free article] [PubMed] [Google Scholar]