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

Thyrotoxicosis gives rise to a high output cardiac failure. Rarely, it can cause a dilated cardiomyopathy with severe impairment of myocardial function which improves significantly following treatment.
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PMID:A reversible dilated cardiomyopathy due to thyrotoxicosis. 870 41

Atrial fibrillation is present in approximately 10% of the population aged over 65 years, in whom its presence is associated with a significantly increased morbidity and mortality. Principal complications include reduced cardiac output and the precipitation of heart failure and thromboembolic phenomena, including strokes and peripheral emboli. In the majority of cases atrial fibrillation is associated with ischaemic heart-disease and hypertension. Other important causes are thyrotoxicosis, valvular heart-disease and atrial septal defect. The primary aims of treatment in atrial fibrillation are to terminate the arrhythmia (cardioversion) with either drugs or direct current (DC) shock and to prevent its recurrence. Effective cardioversion may necessitate the treatment of underlying pathology. If these primary aims cannot be achieved then an attempt must be made to effectively control the ventricular rate with drugs such as digoxin. Recently, further strong evidence has been provided to support the role of anticoagulants and antiplatelet drugs in preventing the major problem of systemic thromboembolic complications. Some of the special difficulties relating to the treatment of atrial fibrillation associated with thyrotoxicosis as well as paroxysmal atrial fibrillation will also be considered.
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PMID:The causes and management of atrial fibrillation. 873 82

Atrial fibrillation is a frequent arrhythmia which has a high prevalence after 65 years of age, thus the typical patient's age is about 75. There are two atrial fibrillation predictors: traditional factors of cardiovascular risk (age, male sex, high blood pressure, diabetes), and structural heart disorders (heart failure, valvular heart disease). All preventive measures to reduce atrial fibrillation incidence, must be directed towards these factors. Additionally, left atrial size, ejection fraction and ventricular hypertrophy are echocardiographic predictors. Atrial fibrillation doubles the mortality rate and is related to an annual stroke rate of 4.5%. The stroke risk factors are: age, hypertension, diabetes, previous stroke, congestive heart failure, coronary heart disease, mitral stenosis, prosthetic heart valves and thyrotoxicosis. Left atrial size and ventricular disfunction are echocardiographic stroke risk factors. Each patient's risk can be stratified on the basis of these factors. All of this information is essential to handle the arrhythmia appropriately; this arrhythmia may be more important than has been thought. Atrial flutter is not very frequent and so it is less studied; however it is an arrhythmia with a similar clinical context to atrial fibrillation, although, probably, with a smaller embolic risk.
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PMID:[Epidemiology, risk factors, and pathogeny of atrial fibrillation and atrial flutter]. 875 90

Thyrotoxicosis rarely precipitates heart failure. Older patients and those with underlying cardiac disease are at greater risk of experiencing this complication of thyrotoxicosis. A 43 year old male who presented with subclinical thyrotoxicosis, atrial fibrillation, and a dilated cardiomyopathy is discussed. There was no evidence of clinically significant underlying cardiac disease. At admission, the patient had an ejection fraction of 25%. Thyrotoxicosis was treated with propylthiouracil. At 14 weeks after hospitalization, the patient had an ejection fraction of 50% with significant reduction in cardiac chamber sizes and left ventricular mass index. He was biochemically euthyroid at that time. After ten months of propylthiouracil therapy, he had progressive improvement in cardiac function and decrease in left ventricular mass index. Thyrotoxicosis-associated cardiomyopathy may reverse significantly with treatment of thyrotoxicosis alone; this complication of thyrotoxicosis should be considered in any young individual with a dilated cardiomyopathy of unknown etiology.
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PMID:Significant reversal of thyrotoxicosis-associated dilated cardiomyopathy with induction of the euthyroid state. 885 93

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

Thyrotoxicosis may precipitate atrial fibrillation, myocardial ischemia or heart failure if underlying heart disease is present. However, reversible dilated cardiomyopathy is rare. We report a case of a 51-year-old man with thyrotoxicosis and dilated cardiomyopathy that was reversed with antithyroid treatment.
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PMID:[Reversible dilated cardiomyopathy and hyperthyroidism]. 903 81

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

Amiodarone-associated thyrotoxicosis, often clinically mild and resolutive after amiodarone discontinuation or under medical therapy, is sometimes drug unresponsive and not uncommonly follows a dramatic, even fatal course. Therefore, we considered a surgical solution in 15 severely amiodarone-associated thyrotoxic patients. Twelve men and three women (mean age 68 years, range 50-84 years) underwent radical thyroidectomy for clinical and biologically proved amiodarone-associated thyrotoxicosis. In six surgery was the first-line therapeutic option. In the other nine thyroidectomy seemed unavoidable considering the unresponsiveness to medical therapy and rapid deterioration of the patients' clinical condition, with life-threatening cardiac failure in three. In every patient surgery was conducted without immediate or delayed complications. Total thyroidectomy proved uniformly, definitively, and rapidly effective in controlling thyrotoxicosis in all patients, with a spectacular reversal of cardiac failure in the three most critical cases. Surgery was beneficial to our 15 patients and undoubtedly life-saving in the three most worrying cases. These results suggest that thyroidectomy should be more liberally regarded as an interesting alternative to conventional, but unpredictably effective, medical therapies.
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PMID:Surgical management of amiodarone-associated thyrotoxicosis: too risky or too effective? 959 25

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and its prevalence increases with age. Etiologies include coronary artery disease, hypertension, valvular heart disease, thyrotoxicosis, and other cardiac and noncardiac conditions. AF can lead to reversible impairment of left ventricular (LV) function, LV dilatation, clinical heart failure, angina pectoris, stroke, and increased mortality. Digoxin, beta blockers, or calcium channel blockers are used to control ventricular rate in new-onset AF with hemodynamically stable rhythm and in chronic AF where rhythm cannot be restored. These drugs can be used alone or in combination, depending on the clinical situation. The most complete relief of symptoms occurs when sinus rhythm is restored. Class IA, IC, and III antiarrhythmic agents can be used to restore and maintain sinus rhythm in selected patients.
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PMID:Atrial fibrillation: drug therapies for ventricular rate control and restoration of sinus rhythm. 963 6

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


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