Thyrotoxic heart

Thyrotoxic heart

Thyrotoxic heart is a clinical syndrome of myocardial damage due to direct or indirect exposure to excessive amounts of thyroid hormones. Etiology and pathogenesis

    • Hyperthyroxine and triiodothyroninemia
    • Uncoupling of oxidative phosphorylation in the myocardium
    • Decreased formation of ATP and creatinine phosphate
    • Compensatory increase in glycolysis and protein breakdown, decrease in protein and glycogen synthesis in cardiomyocytes
    • Decreased concentration of potassium ions and threshold excitability of cardiomyocytes, creating conditions for atrial fibrillation.

Clinical picture

    • Sinus tachycardia – observed in 99% of cases of toxic goiter
    • Atrial fibrillation (in 10-20% of patients), especially its paroxysmal form, may be the only symptom of toxic goiter
    • Systolic arterial hypertension
    • cardiomegaly
    • Heart failure (15-25% of cases)
    • Angina pectoris (relative coronary insufficiency due to increased myocardial oxygen demand).

Laboratory research

    • Elevated levels of iodine bound to serum proteins
    • Increased accumulation of iodine in the thyroid gland.

Differential Diagnosis

    • ischemic heart disease
    • Myocarditis
    • Rheumatic heart disease
    • tuberculosis intoxication.

Drug therapy

    • Thyrostatic products (mercasolil)
    • Potassium preparations
    • (3-Adrenergic blockers. Surgical treatment – resection of the thyroid gland (total or subtotal).

Synonym. Thyrotoxic myocardial dystrophy See also Diffuse toxic goiter, Hyperthyroidism, Thyrotoxic ICD crisis. 143.8 Cardiomyopathy in other diseases classified elsewhere



Leave a Comment

Your email address will not be published. Required fields are marked *