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心脏之外的室上性心动过速:一例以室上性心动过速发作为表现的未确诊格雷夫斯甲状腺毒症病例。

Supraventricular Tachycardia Beyond the Heart: A Case of Undiagnosed Graves' Thyrotoxicosis Presenting as an Episode of Supraventricular Tachycardia.

作者信息

Riasat Muhammad Haroon, Ravikumar Aparna, Nafees Samraiz, Akbar Shahzad, Bakht Khush

机构信息

Diabetes and Endocrinology, York and Scarborough Teaching Hospitals NHS Foundation Trust, Scarborough, GBR.

Internal Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust, Scarborough, GBR.

出版信息

Cureus. 2025 Jun 9;17(6):e85594. doi: 10.7759/cureus.85594. eCollection 2025 Jun.

Abstract

Thyrotoxicosis is a hypermetabolic condition defined by elevated levels of triiodothyronine (T3) and/or thyroxine (T4) in the serum. While irregular heart rhythms like atrial fibrillation are commonly linked to this condition, other types such as supraventricular tachycardia (SVT) characterized by sudden onset, narrow QRS complexes, and regular RR intervals in the absence of structural heart disease are much less frequently reported and often overlooked.  We present a compelling case of Graves' thyrotoxicosis in a middle-aged male patient, whose only presenting symptom was SVT, in the absence of typical systemic signs of hyperthyroidism or structural cardiac abnormalities. This case challenges the conventional diagnostic trajectory of thyrotoxicosis, emphasizing the importance of including thyroid function testing in the diagnostic workup of unexplained arrhythmias. Early recognition of such atypical presentations is crucial, as appropriate treatment of the underlying thyrotoxicosis can lead to resolution of the arrhythmia and improved clinical outcomes.

摘要

甲状腺毒症是一种高代谢状态,定义为血清中三碘甲状腺原氨酸(T3)和/或甲状腺素(T4)水平升高。虽然心房颤动等心律失常通常与这种情况有关,但其他类型,如室上性心动过速(SVT),其特点是突然发作、QRS波群狭窄且RR间期规则,在无结构性心脏病的情况下,报道较少且常被忽视。我们报告了一例中年男性Graves甲状腺毒症患者,其唯一的症状是室上性心动过速,无典型的甲状腺功能亢进全身症状或结构性心脏异常。该病例挑战了甲状腺毒症的传统诊断路径,强调了在不明原因心律失常的诊断检查中进行甲状腺功能测试的重要性。早期识别这种非典型表现至关重要,因为对潜在甲状腺毒症的适当治疗可导致心律失常的缓解并改善临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7773/12239044/1b1f620be7b2/cureus-0017-00000085594-i01.jpg

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