The Importance of Hyperthyroid Screening in Acute Decompensated Heart Failure with Persistent Tachycardia Despite Optimal Decongestion: A Case Report
Background: Hyperthyroid has various effects on the cardiovascular system. Cardiac arrhythmias ranging from sinus tachycardia to atrial fibrillation and low/high cardiac output state to congestive heart failure are observed in patients with hyperthyroidism. If hyperthyroidism is recognized and treated early, the cardiac dysfunction could be corrected. This case presentation will discuss the importance of thyroid function screening.
Case Illustration and Discussion: A man was admitted to the emergency department with signs and symptoms of acute decompensated heart failure. Further examination was performed to confirm the diagnosis, namely ECG, laboratory examination including thyroid function test, and echocardiography. During hospitalization, heart failure medication was given and up titrated. The patient was still tachycardia until hyperthyroid was corrected with anti-thyroid medicines.
Conclusion: Hyperthyroidism can cause or worsen left ventricular dysfunction, especially in individuals with a history of cardiovascular disease. Thus, thyroid function tests should be assessed during initial laboratory examination, especially on patients with acute decompensated heart failure.
2. Vale C, Neves JS, Hafe M Von, Borges-canha M, Leite-moreira A. The Role of Thyroid Hormones in Heart Failure. Cardiovasc Drugs Ther. 2019:3-10.
3. Muthukumar S, Sadacharan D, Ravikumar K. A Prospective Study on Cardiovascular Dysfunction in Patients with Hyperthyroidism and Its Reversal After Surgical Cure. World J Surg. 2016;40:622-628.
4. Jabbar A, Pingitore A, Pearce SHS, Zaman A, Iervasi G, Razvi S. Thyroid hormones and cardiovascular disease. Nat Publ Gr. 2016;14:39-55.
5. Yakasai BA, Yakasai HB. A Case Report On Congestive Cardiac Failure Due To Hyperthyroidism. J Clin Trials Cardiol. 2018;5:1-4.
6. Khan R, Sikanderkhel S, Gui J, Adeniyi A-R, Dell KO, Erickson M, Malpartida J, Mufti Z, Khan T, Mufti H, Al-Adwan SA, Alvarez D, Davis J, Pendley J, Patel D. Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure. Cardiol Res. 2020;11:68-75.
7. Grais IM, Sowers JR. Thyroid and the Heart. Am J Med. 2015;127:691-698.
8. Siu C, Yeung C, Lau C, Kung AWC, Tse H. Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism. Hear Fail Cardiomuopathy. 2007;93:483-487.
9. Biondi B. Heart failure and thyroid dysfunction. Eur J Endocrinol. 2012;167:609-618.
10. Ertek S, Cicero AF. Hyperthyroidism and cardiovascular complications : a narrative review on the basis of pathophysiology. Arch Med Sci. 2013;5:944-952.
11. Fukuda S, Hozumi T, Muro T, Watanabe H, Hyodo E, Yoshiyama M, Takeuchi K, Yoshikawa J. Detection of Coronary Artery Stenosis by Phasic Changes in Myocardial Blood Volume by Intravenous Myocardial Contrast Echocardiography in Humans *. J Echocardiogr. 2004;2:1-6.
12. Anakwue RC, Onwubere BJC, Anisiuba BC, Ikeh VO, Mbah A, Ike SO. Congestive heart failure in subjects with thyrotoxicosis in a black community. Vasc Health Risk Manag. 2010;6:473-477.
13. Chahine J, Alvey H. Left Ventricular Failure. StatPearls.
14. Hoffman JIE, Buckberg GD. The Myocardial Oxygen Supply : Demand Index Revisited. J Am Heart Assoc. 2014;3:1-10.
15. Pothineni NV, Kovelamudi S, Paydak H. Tachycardia in a Patient With Heart Failure. JAMA Intern Med. 2020:8-10.
16. Albakri A. Thyrotoxic heart failure : A review of clinical status and meta-analysis of electrocardiogram diagnosis and medical clinical management methods. Integr Mol Med. 2018;5:1-11.
17. Osuna PM, Udovcic M, Sharma MD. Hyperthyroidism and the heart. MDCVJ. 2017;XIII:60-63.
18. Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, Laurberg P, Mcdougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN. Hyperthyroidism and Other Causes of Thyrotoxicosis : Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. 2012;21.
19. Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels M, Sosa JA, Stan MN. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. 2016;26.
Full Text (PDF) downloads: 205
Copyright (c) 2023 Indonesian Journal of Cardiology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).