Hadzalic Hasan, Hasific Selma, Oechslin Luca, Gaemperli Oliver, Biaggi Patric
Heart Clinic Zurich, Hirslanden Hospital, Witellikerstrasse 40, 8032 Zurich, Switzerland.
Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C, Denmark.
Eur Heart J Case Rep. 2025 Apr 10;9(4):ytaf184. doi: 10.1093/ehjcr/ytaf184. eCollection 2025 Apr.
Graves' disease is linked to a range of cardiovascular diseases. However, the association of new-onset hyperthyroidism with bioprosthetic valve thrombosis has not been reported yet.
We present the case of a 59-year-old Caucasian male who developed new-onset overt hyperthyroidism 6 years after undergoing bioprosthetic mitral valve replacement. Echocardiography revealed valve failure with high transmitral gradients caused by valve thrombosis. Following appropriate thyreostatic treatment and anticoagulation, his symptoms resolved, and subsequent evaluations showed resolution of the thrombus and normal valve function.
In this case, the association of new-onset hyperthyroidism with bioprosthetic valve thrombosis is highly likely. Hyperthyroidism, characterized by a hypercoagulable state and hypofibrinolytic disorder, is known to be associated with thrombosis and thromboembolic events. As acute hyperthyroidism shows clinical features similar to endocarditis, an interdisciplinary approach, immediate appropriate diagnostic steps and management are crucial for a favourable outcome. This case suggests that hyperthyroidism should be considered in the differential diagnosis when evaluating new-onset valvular thrombosis.
格雷夫斯病与一系列心血管疾病有关。然而，新发甲状腺功能亢进症与生物瓣血栓形成之间的关联尚未见报道。
我们报告一例59岁白种男性病例，该患者在接受生物瓣二尖瓣置换术后6年出现新发显性甲状腺功能亢进症。超声心动图显示因瓣膜血栓形成导致瓣膜功能衰竭，跨二尖瓣压差升高。经过适当的抗甲状腺治疗和抗凝治疗后，他的症状得到缓解，随后的评估显示血栓溶解，瓣膜功能恢复正常。
在本病例中，新发甲状腺功能亢进症与生物瓣血栓形成之间极有可能存在关联。甲状腺功能亢进症以高凝状态和纤溶功能减退为特征，已知与血栓形成和血栓栓塞事件有关。由于急性甲状腺功能亢进症的临床特征与心内膜炎相似，因此多学科方法、及时恰当的诊断措施和治疗对于取得良好预后至关重要。该病例提示，在评估新发瓣膜血栓形成时，鉴别诊断应考虑甲状腺功能亢进症。
