Khandwala Hasnain M
Department of Medicine, Division of Endocrinology, University of Saskatchewan, Saskatoon, SK, Canada.
South Med J. 2004 Oct;97(10):1001-3. doi: 10.1097/01.SMJ.0000125100.10857.54.
Thyrotoxicosis is an uncommon cause of low-output congestive heart failure. The case of a 41-year-old male who presented with severe symptomatic congestive heart failure, and was subsequently diagnosed with dilated cardiomyopathy secondary to hyperthyroidism, is presented. The cause of his hyperthyroidism was Graves disease. Despite an initial left ventricular systolic ejection fraction of 20% and evidence of global hypokinesis on echocardiography, treatment with antithyroid agents led to rapid improvement in his clinical status and normalization of his ejection fraction. The proposed mechanisms underlying the development of systolic dysfunction in thyrotoxicosis are discussed, and the literature on similar cases previously reported is reviewed.
甲状腺毒症是低输出量性充血性心力衰竭的罕见病因。本文报告了一名41岁男性患者,他因严重的症状性充血性心力衰竭就诊,随后被诊断为继发于甲状腺功能亢进的扩张型心肌病。其甲状腺功能亢进的病因是格雷夫斯病。尽管初始左心室收缩射血分数为20%,且超声心动图显示整体运动减弱,但使用抗甲状腺药物治疗后,他的临床状况迅速改善,射血分数恢复正常。本文讨论了甲状腺毒症时收缩功能障碍发生的潜在机制,并回顾了此前报道的类似病例的文献。