Case report: reversible mitral regurgitation and congestive heart failure complicating thyrotoxicosis

The American Journal of the Medical Sciences
N G CavrosH L Estep

Abstract

Congestive heart failure is a relatively uncommon manifestation of thyrotoxic heart disease, and different mechanisms have been proposed. The authors present a possible explanation of congestive heart failure in some cases of thyrotoxicosis. A 39 year-old woman with Graves' disease was hypermetabolic, in atrial fibrillation, and had signs of congestive heart failure. She had a loud murmur of mitral regurgitation, clinical cardiomegaly, accentuated pulmonic sound, and peripheral edema. Propranolol reduced the heart rate to 60 beats per minute, but the loud mitral regurgitation murmur persisted. Echocardiographic and angiographic data were consistent with moderate to severe mitral regurgitation, serious enough to consider mitral valve replacement. As the patient's hyperthyroid state came under control, weight increased and the cardiac murmur resolved. After radioactive iodine treatment and the return to a eumetabolic state, an echocardiogram revealed only trace mitral regurgitation, with near normal left ventricular function and pulmonary arterial systolic pressures. These findings were confirmed by subsequent cardiac catheterization. The authors believe that mitral regurgitation, perhaps secondary to intrinsic papillary muscle d...Continue Reading

References

Dec 1, 1994·The American Journal of the Medical Sciences·B E Wilson, S R Newmark

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Citations

Nov 18, 2000·Thyroid : Official Journal of the American Thyroid Association·Y H Yu, J P Bilezikian
Jan 18, 2008·International Journal of Clinical Practice·V SyriouP Vlachoyiannopoulos
Feb 8, 2005·The American Journal of Medicine·Jordi MercéCristóbal Ridao
Dec 1, 2012·Case Reports in Endocrinology·Swapnil Panjabrao GaneshpureVipul Gattani
Aug 15, 2003·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Cristina BoccalandroChik Fong Wei

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