Arora Kanupriya, Panda Prasan K
Department of Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
J Family Med Prim Care. 2021 Oct;10(10):3919-3921. doi: 10.4103/jfmpc.jfmpc_265_21. Epub 2021 Nov 5.
The triad of palpitation, angina, and murmur is a classical feature of cardiac pathology. However, their presence sometimes uncovers a thyroid etiology. Identification well in time decreases out-of-pocket expenditures on illness and suffering. We report a case of a 40-year-old woman who presented with fever with chills, vomiting, palpitations, and shortness of breath for the past month. Also, she described chest pain as typical of angina. Multiple diagnoses were made elsewhere, but none of the treatments resulted in the resolution of symptoms. ST changes were suggestive of ischemic pathology, cardiac MRI done showed up hypertrophied myocardium. After a negative blood culture for infective endocarditis and serology sought for fever work-up, suspicious cardiac examination with a murmur, and an abnormal thyroid profile with a thyroid scan, led to a diagnosis of Graves' disease. This case defines the triad in a noncardiac patient and emphasizes what a thyroid disease does to the heart.
心悸、心绞痛和杂音三联征是心脏病理学的经典特征。然而，它们的出现有时揭示了甲状腺病因。及时识别可减少疾病和痛苦的自付费用。我们报告一例40岁女性病例，她在过去一个月出现发热伴寒战、呕吐、心悸和呼吸急促。此外，她描述胸痛为典型的心绞痛。在其他地方进行了多种诊断，但没有一种治疗能使症状缓解。ST段改变提示缺血性病变，心脏磁共振成像显示心肌肥厚。在感染性心内膜炎血培养阴性以及为发热检查进行血清学检查后，可疑的心脏检查发现杂音，甲状腺扫描显示甲状腺功能异常，最终诊断为格雷夫斯病。该病例界定了非心脏疾病患者中的三联征，并强调了甲状腺疾病对心脏的影响。
