Koike R, Suma H, Oku T, Satoh H, Sawada Y, Matsuyama N, Takeuchi A, Funauchi T, Ishimura T, Wakabayashi A
Department of Thoracic Surgery, Osaka Medical College, Takatsuki, Japan.
Jpn Circ J. 1989 Apr;53(4):336-40. doi: 10.1253/jcj.53.336.
There is a clinical dilemma in the treatment of patients with hypothyroidism and coronary artery disease; excess thyroid hormone administration may exacerbate anginal symptoms, and yet inadequate thyroid replacement may induce congestive heart failure. A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism is described in this paper. A 55 year-old woman with this complication initially received thyroid replacement therapy under strict monitoring. Forty days after the start of the thyroid replacement therapy, serum levels of thyroid hormone had reached the normal range, and then coronary artery bypass grafting was successfully performed. She recovered without any complications, and is now free from chest pain in spite of thyroid replacement therapy.
甲状腺功能减退合并冠状动脉疾病患者的治疗存在临床难题；给予过多甲状腺激素可能会加重心绞痛症状，但甲状腺激素替代不足又可能诱发充血性心力衰竭。本文描述了一例心绞痛合并甲状腺功能减退患者成功进行冠状动脉旁路移植术的病例。一名患有此并发症的55岁女性最初在严格监测下接受甲状腺激素替代治疗。甲状腺激素替代治疗开始40天后，甲状腺激素血清水平已达到正常范围，随后成功进行了冠状动脉旁路移植术。她康复过程中未出现任何并发症，尽管仍在接受甲状腺激素替代治疗，但现在已无胸痛症状。
