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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of a pregnant woman who underwent urgent cesarean section is presented. The patient had severe hyperthyroidism, preeclampsia, and congestive heart failure, which had not been treated until 36 weeks of gestational age. At 38 weeks, fetal distress occurred and an urgent cesarean section was performed successfully under epidural anesthesia with preoperative treatments using iodide, hydrocortisone and propylthiouracil. The patient required postoperative intensive care for heart failure. Thyroid function of the neonate was almost normal. No abnormality was observed except low birth weight.
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PMID:[Cesarean section in a patient with uncontrolled hyperthyroidism, preeclampsia, and congestive heart failure]. 886 14

Systolic heart failure because of hyperthyroidism in patients without preexisting heart disease is not common. Thyrotoxic systolic heart failure is rarely diagnosed during life. Reports about thyrotoxicosis-related systolic heart failure have been diagnosed postmortem. However, antemortem diagnosis of this fatal disease has important clinical implications because if detected early, thyrotoxicosis-related systolic heart failure is reversible. Here is a report a patient with Graves' disease, systolic heart failure, and deep jaundice, which resolved after the treatment of antithyroid drugs.
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PMID:Case report: reversible systolic heart failure and deep jaundice in hyperthyroidism. 890 Mar 90

We report two cases of hyperthyroidism clinically associated to edema, in which no usual causes for the latter were found. Correction of the hyperthyroidism state was associated with complete resolution of edema. The fact that one of the cases consisted of a farmacologically induced hyperthyroidism points to a direct effect of the thyroid hormone itself as the origin of this complication. The de novo occurrence of edema can be due to thyroid hyperfunction as the only underlying cause, the presence of other associated factors such as heart failure, hypoproteinemia or dermopathy not being necessary for its development.
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PMID:[Edema as clinical manifestation of hyperthyroidism. Report of 2 cases]. 894 19

The cardiac manifestations of the hyperthyroidism (HT) are diverse and frequent. However, sometimes, the initial symptoms are atypical and are difficult to diagnose. We present the case of a patient whose HT began with heart failure secondary to a severe tricuspid regurgitation (IT). This data suggests that when confronted with IT of unclear etiology, a possible HT must be investigated.
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PMID:[Severe tricuspid insufficiency as main manifestation of hyperthyroidism]. 930 83

Neonatal thyrotoxicosis may occur by transplacental transfer of thyroid stimulating immunoglobins from the mother. Although the clinical manifestations may vary in the new-born period, hyperthyroidism has been associated with several cardiac complications including supraventricular tachycardia, cardiomyopathy and congestive cardiac failure. We report the case of a nine day old baby who presented with severe pulmonary hypertension in association with congestive cardiac failure secondary to neonatal thyrotoxicosis. Treatment of the heart failure and restoration of the thyroid function resulted in complete regression of the pulmonary hypertension. The recognition and reversibility of pulmonary hypertension in neonatal Graves disease has not been previously described.
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PMID:Reversible pulmonary hypertension in neonatal Graves disease. 926 95

Congenital hyperthyroidism is a very rare disease. But, for each affected child it has to be considered as a serious condition because of the negative impact of hyperthyroidism on fetal and postnatal development. If the manifestation occurs during fetal life tachycardia, cardiac arrhythmia, growth retardation and, most significant, prematurity are the consequences. Postnatal signs of hyperthyroidism are irritability, tachycardia, hypertension, poor weight gain and thyroid enlargement. Even cardiac failure may occur if hyperthyroidism is severe and treatment not adequate which explains the high early mortality rate of 16%. The main complication of persistent hyperthyroidism in the neonatal period and during infancy is craniosynostosis. Severe developmental delay or even mental retardation can be the consequence of inadequate high T4-levels during fetal and neonatal life. Congenital hyperthyroidism was first recognized in infants born to mothers with Graves' disease. The description of transplacental passage of the maternal thyroid stimulating antibodies elucidated the molecular mechanism in this major group of patients with "autoimmune congenital hyperthyroidism". In contrast to this transient, self-limited character of "autoimmune congenital hyperthyroidism", due to the clearance of maternal antibodies from the infant's circulation, some cases of persistent congenital hyperthyroidism without signs of thyroid autoimmunity have been recognized. Activating mutations in the thyroid-stimulating hormone receptor were described recently as the underlying molecular pathogenesis in this group of "non-immune congenital hyperthyroidism". Therefore the possibility of a molecular differential diagnosis of both groups of congenital hyperthyroidism now exists and opens the opportunity of optimal treatment for each patient.
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PMID:Congenital hyperthyroidism. 943 7

Atrial fibrillation (AF) is one of the most frequent dysrhythmias in patients coming to emergency departments (EDs), and pharmacological treatment is frequently performed. The aim of this randomized placebo-controlled multicenter trial was to compare propafenone (a class 1C antidysrhythmic agent), administered i.v. in the ED, with placebo in the treatment of recent-onset AF (<72 h). We randomly allocated 156 patients (88 males; 68 females) from 18 to 80 years old, with recent-onset AF, to receive i.v. propafenone (2 mg/kg for 10 min) or the matching placebo. The patients were followed for 2 h. Exclusion criteria were the presence of one of the following: lack of informed consent, clinical evidence of heart failure, clinical hyperthyroidism, recent acute myocardial infarction, atrioventricular block, cardiac valve dysfunction, a history of bronchial asthma, and current treatment with antidysrhythmic agents including digitalis. The two groups did not differ significantly in terms of sex, age, body weight, or estimated time elapsed since the beginning of atrial fibrillation. Conversion to sinus rhythm occurred in 13 of the 75 patients who received the placebo (17.3%) and in 57 of the 81 patients who were given propafenone (70.3%). In conclusion, intravenous propafenone administration in the ED can be considered a safe and effective approach for converting AF to sinus rhythm.
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PMID:Intravenous propafenone for converting recent onset atrial fibrillation in emergency departments: a randomized placebo-controlled multicenter trial. FAPS Investigators Study Group. 961 Sep 64

Thyroid storm is a difficult diagnosis in "apathetic" variant of hyperthyroidism. The clinical features may not be evident. Abnormal atrioventricular (AV) conduction, such as complete heart block, in thyrotoxicosis is uncommon. We report a case of a 16-year-old girl presenting with fever, jaundice, heart failure and complete heart block in whom the diagnosis of thyroid storm was initially missed because of the unusual presenting features. Prompt resolution of the conduction abnormality occurred when treatment with carbimazole, intravenous iodide and dexamethasone was instituted.
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PMID:Thyroid storm presenting as jaundice and complete heart block. 991 55

The importance of cardiovascular system involvement in hyperthyroidism has been recognized for many years. In the elderly patient, often with mild but prolonged elevation of plasma thyroid hormones, symptoms and signs of heart failure and complicating atrial fibrillation (AF) may dominate the clinical picture and mask the more classic endocrine manifestations of the disease. Impaired cardiopulmonary function and exercise capacity, significantly more marked in older patients, is observed in hyperthyroidism. Thyrotoxicosis can aggravate pre-existing heart disease and can also lead to AF, congestive heart failure, or worsening of angina pectoris. Regarding the high incidence of AF in older patients with hyperthyroidism, it is also important to detect subclinical hyperthyroidism in older patients with AF, thus warranting the measurement of the serum thyrotropin (TSH) concentration for early recognition and treatment. Most cardiac abnormalities return to normal once a euthyroid state has been achieved, although AF may persist in a minority. Optimal treatment requires rapid and definitive antithyroid therapy. Furthermore, anticoagulation is recommended for thyrotoxic patients with AF older than 50 years, those who have histories of previous emboli, hypertension, or with echocardiographic evidence of left atrial enlargement and/or myxomatous valves.
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PMID:Cardiac risks of hyperthyroidism in the elderly. 992 Mar 73

The appearance of moderate jaundice with mildly raised levels of plasma bilirubin is an uncommon complication of thyrotoxicosis and is usually accompanied by signs of right heart failure. Some described cases were actually related, at least in part, to autoimmune chronic hepatitis. In this paper we describe a case of thyrotoxicosis accompanied by deep jaundice with very high levels of bilirubin occuring in the absence of cardiac failure and with no signs of hepatitis. Jaundice disappeared shortly after the start of thyrostatic drug treatment, supporting a possible detrimental effect of hyperthyroidism on the hepatic bilirubin metabolism.
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PMID:Appearance of severe jaundice after radiometabolical treatment of thyrotoxicosis. 1021 89


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