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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The lack of equivalence in the distrubtion of normal ranges for free thyroxine index (FT4I) and free triiodothyronine index (FT3I) in the over sixty-five age-group, as compared with the fifteen-sixty-five age-group, supports the idea that "T4 toxicosis" is a common biochemical finding in elderly women. The disparity between FT4I and FT3I ranges was also reflected in the true free T4 and free T3 levels which were measured in some cases. These results suggest that when an increased FT4I is found in an elderly woman with cardiac disease, caution should be exercised in interpreting the result as indicating that thyrotoxicosis is the cause of the cardiac disorder. Estimation of total T3, FT3I, or free T3 seems useful in confirming euthyroidism in such cases.
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PMID:Is "T4 toxicosis" a normal biochemical finding in elderly women? 4 41

A 68-year-old man with a history of organic heart disease and marked weight loss was found to have apathetic thyrotoxicosis and hypercalcemia. Oral propranolol, 20.0 mg four times a day, provoked a gradual fall in serum calcium and alkaline phosphatase. It is concluded that relatively small doses of oral propranolol may be effective in the management of hypercalcemia accompanying thyrotoxicosis and that beta-blocking agents may not only inhibit the enhanced bone resorption caused by thyroid hormones but also block the stimulated osteoblastic activity.
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PMID:Oral propranolol in hypercalcemia associated with apathetic thyrotoxicosis. 66 23

The frequency, clinical characteristics, and outcome of patients admitted with heart failure to a district general hospital in North-West London serving a population of approximately 155,000 was assessed over a six-month period. The number of patients with heart failure was determined by both a prospective ward survey and a retrospective study of all patient records with diagnostic codes for heart failure or pulmonary oedema. During those six months, 2,877 patients were admitted to the medical and geriatric services of whom 140 (4.9%) had heart failure. Only 29 patients in heart failure were under the age of 65 years. In 86 patients the mode of presentation was acute pulmonary oedema. Fifty-two (37%) patients had an arrhythmia at the time of admission of whom 48 had atrial fibrillation. An electrocardiogram, a chest X-ray, and an echocardiogram were performed in 137, 136, and 81 patients respectively. The aetiology of heart failure was considered to be coronary artery disease (41%), valve disease (9%), hypertension (6%), cor pulmonale (4%), a dilated cardiomyopathy (1%), congenital heart disease (1%), thyrotoxicosis (1%), and unknown (36%). During the period of hospital stay 42 patients (30%) died; a further 20 patients (14%) died in a one-year follow-up. In a district general hospital heart failure is a common reason for admission and patients remain in hospital for a considerable time. Arrhythmias are commonly associated with heart failure. The prognosis is poor and the hospital mortality high. The management of heart failure is an important consideration in allocating hospital resources in a district general hospital.
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PMID:Heart failure in a district general hospital. 842 54

Atrial fibrillation (AF) is found in 0.4% of adults younger than age 60 years and in 2 to 4% older than age 60 years, and is associated with a high risk of thromboembolic complications. AF--paroxysmal and chronic--has many etiologies, including rheumatic and nonrheumatic heart disease and thyrotoxicosis. Knowing how strokes occur and what precipitates them--e.g., differentiating between cardioembolic and cerebrovascular causes--is important when deciding on appropriate treatment. Risk factors involved in the development of thromboembolic complications associated with AF are reviewed, focusing on the contributions of thyrotoxic AF, paroxysmal AF (and its transition to chronic AF), enlargement of the left atrium, silent cerebral infarction and decreased cerebral blood flow. Data from several studies are briefly presented, highlighting major outcomes. On the basis of current information about prevention of thromboembolic complications, it seems reasonable to recommend anticoagulant treatment for patients with nonrheumatic chronic AF.
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PMID:Thromboembolic complications of atrial fibrillation and their prevention: a review. 213 83

Amiodarone hydrochloride, an iodine-rich drug used in the treatment of tachyarrhythmias, is responsible for the development of thyrotoxicosis in approximately 10% of patients who reside in areas of moderate iodine deficiency. Treatment of amiodarone-induced thyrotoxicosis is difficult since the drug has a prolonged half-life, cardiac decompensation due to underlying heart disease occurs often, and discontinuation of amiodarone therapy may not be possible. We report a patient with severe thyrotoxicosis who received amiodarone for 34 months. Prolonged treatment with methimazole, potassium perchlorate, iopanoic acid, and dexamethasone was unsuccessful in controlling the hyperthyroid state. A near-total thyroidectomy resulted in rapid amelioration of thyrotoxicosis. Since surgery results in rapid control of thyrotoxicosis and permits continued therapy with amiodarone, we suggest that near-total thyroidectomy warrants consideration as definitive treatment for resistant amiodarone-induced thyrotoxicosis.
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PMID:Thyroidectomy for amiodarone-induced thyrotoxicosis. 230 84

We report a case of a 37-year-old woman who had paroxysmal ventricular tachycardia (VT) during early pregnancy. She had severe hyperemesis, palpitation at 6 weeks of gestation and many episodes of paroxysmal VT, but no apparent organic heart disease. At that time she had a transient increase of thyroid hormone levels. With bed rest and without medication, her symptoms and episodes of VT disappeared in accordance with the improvement of hyperemesis and thyrotoxicosis. She demonstrated a rare course of arrhythmias in which the deterioration of VT was observed at transient thyrotoxicosis and hyperemesis.
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PMID:A case of paroxysmal ventricular tachycardia during pregnancy. 281 Jun 90

In this study the mechanism responsible for atrial fibrillation (AF) in hyperthyroidism was investigated by standard cardiovascular exploration and echocardiography. Fifty four patients (43 women, 11 men, mean age 44 years) were examined during, and after successful treatment of a thyrotoxicosis episode associated with Graves' disease in 43 cases, with a secondarily toxic goitre in 7 cases and with a toxic adenoma in 4 cases. Nineteen patients presented with a heart disease: mitral valve prolapse (MVP) in 11 (including 4 with AF) and another cardiopathy in 8 (including 4 with AF). Among the 34 patients without heart disease, only 2 had AF during thyrotoxicosis. In all groups the antero-posterior diameter of the left atrium was greater in patients with AF than in those with normal sinus rhythm, but it remained within normal limits in patients with MVP. It may be assumed that in these cases AF resulted from synergism between the arrhythmogenic potential of MVP and that of the thyroid hormones. In contrast, prior dilatation of the left atrium seemed to play a predominant role in patients with another cardiopathy. The 4 patients with AF in the latter group remained with AF after the thyrotoxicosis was cured, whereas the 2 patients without heart disease and 3 of the 4 MVP patients reverted to sinus rhythm without anti-arrhythmic therapy or cardioversion. It is concluded that the presence of an underlying heart disease accounts for most cases of AF developed during thyrotoxicosis, but in 1 out of 2 cases the heart disease in a minor one, consisting of MVP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Auricular fibrillation in hyperthyroidism. Incidence of associated cardiopathy and of dilatation of the left auricle]. 312 Jun 64

Congestive heart failure due to thyrotoxicosis without preexisting heart disease is rare. Indeed, the very existence of a thyrotoxic heart disease has been much discussed. We describe a 44-year-old woman in whom thyrotoxicosis was found to be the sole cause of congestive heart failure.
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PMID:Congestive heart failure in thyrotoxicosis. 336 May 30

The most frequent clinical manifestations in 100 elderly hyperthyroid patients entered in our study were: weight loss (83%), palpitations (85%), nodular goiter (71%) and tremor (74%). Association of weight loss with anorexia and constipation was found in 6% of the patients. The apathetic form of thyrotoxicosis was present in 2% of our patients. Thyrotoxic atrial fibrillation and thyrotoxic heart disease were found in 42% and 51% respectively.
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PMID:Hyperthyroidism in the elderly. I. Clinical manifestations. 383 36

The T(4)-free thyroxine index was used as the thyroid function test of first choice in a district general hospital for one year. Ninety-two patients were assessed both initially and at follow up by a single physician. The index agreed with clinical assessment in 69 out of 74 patients in whom diagnosis was unequivocal. There was initial doubt about thyroid status in 14 patients; after re-assessment the index agreed with status in seven cases, in three cases there is still some uncertainty, whilst the index was at variance with clinical status in four patients. Some possible causes of discrepancy between clinical thyroid status and the index are a low index in euthyroid patients due to a fall in serum thyroxine-binding prealbumin (;sick euthyroid'), a raised index in euthyroid patients due to latent thyroid heart disease, and a normal index in thyrotoxicosis due to preferential secretion of triiodothyronine.
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PMID:The T 4 -free thyroxine index as a test of thyroid function of first choice. 462


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