甲状腺功能亢进症与严重心动过缓：三例报告并文献复习

Hyperthyroidism and severe bradycardia: Report of three cases and review of the literature.

作者信息

He Yang-Li, Xu Wen-Xing, Fang Tuan-Yu, Zeng Min

机构信息

Center of Geriatrics, Hainan General Hospital, Haikou 570311, Hainan Province, China.

Hainan Clinical Research Center for Cardiovascular Disease, Hainan General Hospital, Haikou 570311, Hainan Province, China.

出版信息

World J Clin Cases. 2023 Mar 6;11(7):1549-1559. doi: 10.12998/wjcc.v11.i7.1549.

DOI:10.12998/wjcc.v11.i7.1549

PMID:36926388

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10011989/

Abstract

BACKGROUND

Hyperthyroidism often leads to tachycardia, but there are also sporadic reports of hyperthyroidism with severe bradycardia, such as sick sinus syndrome (SSS) and atrioventricular block. These disorders are a challenge for clinicians.

CASE SUMMARY

We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search. Through the analysis of these 34 cases, we found 21 cases of atrioventricular block and 13 cases of SSS, with 67.6% of the patients experiencing bradycardia symptoms. After drug treatment, temporary pacemaker implantation, or anti-hyperthyroidism treatment, the bradycardia of 27 patients (79.4%) was relieved, and the median recovery time was 5.5 (2-8) d. Only 7 cases (20.6%) needed permanent pacemaker implantation.

CONCLUSION

Patients with hyperthyroidism should be aware of the risk of severe bradycardia. In most cases, drug treatment or temporary pacemaker placement is recommended for initial treatment. If the bradycardia does not improve after 1 wk, a permanent pacemaker should be implanted.

摘要

背景

甲状腺功能亢进症常导致心动过速，但也有散发性甲状腺功能亢进症伴严重心动过缓的报道，如病态窦房结综合征（SSS）和房室传导阻滞。这些病症对临床医生来说是一项挑战。

病例摘要

我们描述了3例甲状腺功能亢进症合并SSS的病例，并在PubMed文献检索中发现了31例类似病例。通过对这34例病例的分析，我们发现21例房室传导阻滞和13例SSS，67.6%的患者有心动过缓症状。经过药物治疗、临时起搏器植入或抗甲状腺功能亢进治疗后，27例患者（79.4%）的心动过缓得到缓解，中位恢复时间为5.5（2 - 8）天。仅7例（20.6%）需要植入永久性起搏器。