Clinical Case Database / Category: Patient Management
Thyrotoxicosis induced heart failure with secundum ASD
Publication details
Dr Heerajnarain Bulluck, Dr Leisa Joan Freeman
Foundation Years Journal, volume 8, issue 2, p.52 (123Doc Education, London, February 2014)
Abstract
Thyrotoxicosis is a rare but reversible cause of pulmonary hypertension and right heart failure. Treatment of the thyroid disorder usually leads to complete normalisation of the pulmonary artery pressure and right ventricular function. This patient had a co-existing secundum atrial septal defect (ASD) which made her management challenging. This case illustrates the interplay of various factors leading to her presentation and subsequent management and the multi-disciplinary team (MDT) approach in her treatment.
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Authors
Dr Heerajnarain Bulluck
Department of Cardiology
Norfolk and Norwich University Hospital
Colney Lane
Norwich, NR4 7UY
h.bulluck@gmail.com
Dr Leisa Joan Freeman
Department of Cardiology
Norfolk and Norwich University Hospital
Colney Lane
Norwich, NR4 7UY
leisa.freeman@nnuh.nhs.uk
References
1. Merce J, Ferras S, Oltra C et al. Cardiovascular abnormailities in hyperthyroidism: a prospective Doppler echocardiographic study. Am J Med 2005; 118:126
2. Siu CW, Zhang XH, Yung C et al. Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study. J Clin Endocrinol Metab 2007; 92:1736
3. Di Giovambattista R. Hyperthyroidism as a reversible cause of right ventricular overload and congestive heart failure. Cardiovasc Ultrasound 2008;6:29.
4. Lozano HF, Sharma CN. Reversible pulmonary hypertension, tricuspid regurgitation and right-sided heart failure associated with hyperthyroidism: case report and review of the literature. Cardiol Rev 2004;12:299–305.
5. Cohen J, Schattner A. Right heart failure and hyperthyroidism: a neglected presentation. Am J Med 2003;115:76–77.
6. Park JH, Shong MH, Lee JH, Choi SW, Jeoung JO, Seong IW. Reversible severe tricuspid regurgitation with right heart failure associated with thyrotoxicosis. Thyroid 2006;16:813–814.
7. Syrius V, Plastiras SC, Paterakis T, Moyssakis I, Vlachoyiannopoulos P. Severe reversible right heart failure in a patient with hyperthyroidism. Int J Clin Pract 2008;62:334–336.
8. Ganeshpure PS, Vaidya GN, Gattani V. Secondary pulmonary hypertension and right-sided heart failure at presentation in Grave’s Disease. Case Reports in Endocrinology 2012;Epub ID 762023.
9. Barst RJ, Loyd JE. Genetics and immunogenetic aspects of primary pulmonary hypertension. Chest 1998;114(3 suppl):231S-236S
10. Ojamaa K, Balkman C, Klein IL. Acute effects of triiodothyronine on arterial smooth muscle cells. Ann Thorac Surg 1993;56:S61-S67
11. Baumgartner H, Bonhoeffer P, De Groot N.M.S et al. ESC guidelines for the management of grownup congenital heart disease. Eur Heart J 2010;31: 2923-2924
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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