Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum triiodothyronine (T3) and thyroxine (T4) levels were measured in twelve hyperthyroid patients before and after treatment with propranolol, 40 mg four times daily, for 2 weeks. There was a significant fall in serum T3 and a significant rise in serum T4 concentrations in the group as a whole and it was concluded that the clinical effectiveness of propranolol in hyperthyroidism may be mediated in part by its action on the peripheral metabolism of thyroid hormones. Propranolol treatment should be withdrawn gradually as removal of the suppressive action of the drug on thyroid hormone metabolism is potentially hazardous, particularly in patients with ischaemic heart disease.
 ...
PMID:Thyroxine and triiodothyronine levels in hyperthyroid patients during treatment with propranolol. 88 Jul 33

A case of myxoedema ascites complicating ischaemic heart disease is reported. Partial thyroid hormone replacement therapy, given slowly, eventually produced a diuresis and complete resolution of the ascites after a delay of 4 weeks.
 ...
PMID:Myxoedema ascites. 88 34

Patients with hypopituitarism are prone to perioperative complications resulting from adrenal insufficiency or hypothyroidism. Coronary artery bypass grafting was performed safely in a 53-year-old woman with postinfarction unstable angina and hypopituitarism. Cortisol and thyroid hormone were administered to maintain normal adrenal and thyroid function during and after the operation. Hydrocortisone was administered intravenously the day before surgery and for 2 weeks postoperatively and then was administered orally. Perioperative replacement thyroxine therapy was administered to avoid acute myocardial ischemia. Optimal thyroid replacement was achieved after surgery. No perioperative complications were seen. The patient remains free of angina with postoperative cortisol and thyroid hormone replacement therapy.
 ...
PMID:[Coronary artery bypass surgery in a patient with hypopituitarism]. 143 11

While angina is not uncommonly seen in association with hyperthyroidism, only rare case reports have suggested that myocardial ischemia in this state may be due to coronary artery spasm. The authors review the literature and describe a case in which the repetitive occurrence of episodes of myocardial ischemia due to coronary spasm correlated with repeated transient elevations in thyroid hormone levels, thus clarifying this relationship. The importance of defining thyroid status in patients presenting with coronary vasospasm is emphasized and the effects of thyroid hormone on the heart are reviewed.
 ...
PMID:Case report: coronary vasospasm--relation to the hyperthyroid state. 164 52

Hypothyroidism and hyperthyroidism are both associated with clinically significant cardiovascular derangements. In hypothyroidism, these include pericardial effusion, heart failure, and the complex interrelationship between hypothyroidism and ischemic heart disease. Cardiovascular disorders associated with hyperthyroidism include atrial tachyarrhythmias, mitral valve dysfunction, and heart failure. Although these usually occur in individuals with intrinsic heart disease, thyroid dysfunction alone rarely causes serious but reversible cardiovascular dysfunction. Patients with commonly encountered cardiac disorders, e.g., idiopathic cardiomyopathy and atrial fibrillation, should be screened for potentially contributing subclinical thyroid diseases. In patients with heart failure and hypothyroidism, initial management should focus on diagnosis and optimal management of any primary cardiac disease, whereas in hyperthyroidism, aggressive measures to control excess thyroid hormone action should generally have the highest priority.
 ...
PMID:Recognition and management of cardiovascular disease related to thyroid dysfunction. 223 96

Treatment for patients with ischemic heart disease and hypothyroidism contains many difficulties, such as a dilemma that thyroid hormone to hypothyroid patients may worsen angina. The purpose of this study is to propose an appropriate control of thyroid function in these patients before coronary artery bypass grafting (CABG), and to clarify the change of thyroid function during postoperative period. Because of progressive angina pectoris, five hypothyroidism patients underwent CABG. Preoperatively, minimal dose of L-Thyroxine (0-75 micrograms, daily) was administered orally to keep thyroid function at slightly low level before CABG. Ten consecutive CABG patients with normal thyroid function were selected as control group. Between both groups, there was no significant difference in age, coronary artery disease, and the number of bypass grafts. Serum T4, free-T4, T3, free-T3, and TSH were measured at 1st, 2nd, 3rd, and 7th P.O.D. In control group, pituitary-thyroid function was suppressed transiently. In hypothyroid group, T4 revealed no change and was kept at slightly low level during observed period. There was no significant difference in postoperative hemodynamics between both groups. Postoperatively all of hypothyroid patients got free from angina and received an adequate thyroid hormone replacement therapy without complications. It is concluded that CABG for patients with angina and hypothyroidism can be performed safely by keeping preoperative thyroid function at slightly low level.
 ...
PMID:[Surgical treatment of ischemic heart disease combined with hypothyroidism]. 221 71

A 52-year-old man with myxedema was evaluated for anterior chest pain that was considered to be compatible with myocardial ischemia. The night after admission he developed extreme bradycardia, hypotension, and apneic episodes lasting up to 25 s. Continuous positive airway pressure and administration of medroxyprogesterone acetate prevented further episodes and relieved much of the somnolence and lethargy that had contributed to the evidence for myxedema. Alveolar hypoventilation caused by decreased sensitivity to carbon dioxide, inadequate central neural drive, peripheral muscle force, and obesity all may have contributed to the apnea. Chest pain has not recurred, and results of electrocardiography have remained normal following full thyroid hormone replacement. The early recognition of myxedema causing sleep apnea will allow specific treatment to avoid the cardiovascular risks related to prolonged apnea and will help avoid confusion with other etiologies of cardiovascular abnormalities.
 ...
PMID:Extreme bradycardia during sleep apnea caused by myxedema. 363 55

The management of hypothyroid patients requiring major cardiovascular surgery is difficult and often controversial. We prospectively studied 500 patients requiring cardiac surgery with cardiopulmonary bypass and found ten with previously undiagnosed mild to moderate hypothyroidism. All ten tolerated surgery well without preoperative thyroid hormone replacement. Our experience with these patients plus an additional five seen in our clinical practice suggests that major cardiovascular surgery can be performed safely in most patients with mild to moderate hypothyroidism. We conclude that untreated hypothyroidism in patients with ischemic heart disease should not be an absolute contraindication to coronary artery bypass surgery.
 ...
PMID:Cardiovascular surgery in the hypothyroid patient. 387 28

"Syndromes related to defective iodothyronine metabolism" have been frequently observed in clinical practice. As for methodological and pathophysiological reasons T4, T3, rT3 and TSH estimations are of limited value in these situations, thus, the interpretation of the laboratory findings becomes frequently difficult. Furthermore determining the individual "whole body"- or "organ-thyroid state" requires more than measuring the serum concentrations of thyroid hormones. Iodothyronine metabolism is strongly organ specific, therefore, alterations in plasma thyroid hormone concentrations cannot reflect the specific cellular and subcellular thyroid hormone concentrations of individual organs. However, there is some experimental evidence, that disease-induced alterations in plasma thyroid hormone levels are a simple reflection of the catabolic state of the organisms. At present the biological implication of altered thyroid hormone economy in non-thyroidal illness should not be considered as an energy sparing, i.e. protein sparing effect, anymore: Thyroid hormones in their physiological concentrations act as anabolic hormones. There is no general indication for substituting diminished T3. Up to now, preliminary data suggest the benefit of T3-substitution in septic shock or in "respiratory distress syndrome". However, the possible benefit of improved cardiovascular of respiratory function should be compared carefully to the harm of the therapy, i.e. T3-induced increase in protein catabolism or possible deterioration in preexisting ischemic heart disease: From a clinical point of view, most of non-thyroidal illness-induced changes in ITH-metabolism seem to implicate a pitfall in physician's diagnosis of the thyroid state rather than a therapeutic question.
 ...
PMID:Syndromes related to defective iodothyronine metabolism. 639 60

Aim of this paper is to review the effects of T4 excess due to exogenous thyroid hormone administration on target organs, with particular regard to heart, bone, liver and pituitary. Therapy with TSH-suppressive doses of T4 has been shown in a cross sectional echocardiographic study to increase left ventricular contractility and to induce mild myocardial hypertrophy. Whether the latter represents a risk for the patients remains a matter of debate. Clinically it does not seem to be important. The long-term evaluation of T4-therapy has provided controversial results. Some have reported that T4-treated patients under the age of 65 have an increased risk of ischemic heart disease, whereas others were unable to find any change in morbidity, mortality and quality of life, including cardiovascular events. Thyroid hormones enhance both osteoblastic and osteoclastic activities in cortical and trabecular bone. Overt hyperthyroidism is well known to represent a risk factor for osteoporosis. Studies in the late eighties have suggested a reduced bone density in T4-treated patients, with a particular risk for cortical bone in postmenopausal women. More recent studies have failed to show any substantial T4-related change in bone mass. Taken together the evidence of the literature suggests that TSH-suppressive therapy with T4 is, if well controlled, probably not associated with significant loss of bone mass at least in premenopausal women. A mild elevation of the activity of hepatic enzymes (glutathione-S-transferase, gamma glutamyltransferase, alanine amino-transferase, angiotensin-converting enzyme) has been observed in patients under T4 treatment in TSH-suppressive doses.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Effects of thyroxine excess on peripheral organs. 799 84


1 2 3 4 Next >>