Toft P, Bøtker H E
Kardiologisk afdeling, Haderslev Sygehus.
Ugeskr Laeger. 1993 May 3;155(18):1354-7.
Cardiac symptoms have a prominent position in hyperthyroidism. The basic haemodynamic change is an increased cardiac output due to an increased stroke volume and an increased heart rate. Dyspnoea and palpitations are frequent symptoms. ECG-changes such as atrial fibrillation, sinus tachycardia, prolonged atrioventricular conduction and ST-segment changes are seen, but such changes are unspecific. Chest X-ray and echocardiographic studies are often normal, but cardiomegaly and ventricular hypertrophy are seen. The cardiac and non-cardiac symptoms of hyperthyroidism may in part be related to an increased sympathoadrenal activity. The thyroid hormones also exert a direct effect on the heart. Treatment includes specific anti-thyroid medication, beta-blocking agents, digoxin, diuretics and possibly anticoagulant therapy. Congestive heart failure, ventricular hypertrophy and arrhythmia are most commonly seen if other cardiac abnormalities are already present. The existence of thyrotoxic cardiomyopathy as an independent disease is illustrated by two case histories, which also demonstrate the reversibility of this condition.
心脏症状在甲状腺功能亢进症中占据显著地位。基本的血液动力学变化是由于每搏输出量增加和心率加快导致的心输出量增加。呼吸困难和心悸是常见症状。可观察到心电图变化，如心房颤动、窦性心动过速、房室传导延长和ST段改变，但这些变化是非特异性的。胸部X线和超声心动图检查通常正常，但也可见心脏扩大和心室肥厚。甲状腺功能亢进症的心脏和非心脏症状可能部分与交感肾上腺活动增加有关。甲状腺激素也对心脏有直接作用。治疗包括特定的抗甲状腺药物、β受体阻滞剂、地高辛、利尿剂以及可能的抗凝治疗。如果已经存在其他心脏异常，则最常出现充血性心力衰竭、心室肥厚和心律失常。两个病例史说明了甲状腺毒症性心肌病作为一种独立疾病的存在，这两个病例史也证明了这种情况的可逆性。
