Takotsubo cardiomyopathy associated with thyrotoxicosis: a case report and review of the literature. [Review]

MedStar author(s):
Citation: Thyroid. 24(2):383-9, 2014 Feb.PMID: 23560557Institution: MedStar Washington Hospital CenterDepartment: Medicine/Endocrinology | Medicine/General Internal MedicineForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal Article | ReviewSubject headings: *Graves Disease/co [Complications] | *Takotsubo Cardiomyopathy/et [Etiology] | *Thyroid Crisis/co [Complications] | Acute Coronary Syndrome/di [Diagnosis] | Aged | Diagnosis, Differential | Female | Humans | Takotsubo Cardiomyopathy/di [Diagnosis] | Thyroid Crisis/di [Diagnosis]Local holdings: Available online from MWHC library: August 2000 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 1050-7256
Name of journal: Thyroid : official journal of the American Thyroid AssociationAbstract: BACKGROUND: Takotsubo or stress-induced cardiomyopathy is a form of reversible cardiomyopathy commonly associated with emotional or physical stress. Thyrotoxicosis has been identified as a rare cause of Takotsubo cardiomyopathy, with only 12 cases reported in the literature. Here, we report a case of thyroid storm presenting with Takotsubo cardiomyopathy in the setting of Graves' disease.CONCLUSIONS: Thyrotoxicosis is associated with adverse disturbances in the cardiovascular system. Takotsubo cardiomyopathy could be a presenting manifestation of thyroid storm, perhaps related to excess catecholamine levels or sensitivity.PATIENT FINDINGS: A 71-year-old woman presented with abdominal pain, vomiting, confusion, and history of weight loss. She was initially diagnosed and treated for diabetic ketoacidosis at another hospital and was transferred to our hospital one day after initial presentation because of concern for acute coronary syndrome. A diagnosis of Takotsubo cardiomyopathy was made on the basis of cardiac catheterization. At that time, she was diagnosed and treated for thyroid storm. Follow-up 7 weeks later revealed improvement of her cardiac function and near-normalization of thyroid hormone levels.SUMMARY: In this patient, who presented with symptoms of heart failure, acute coronary syndrome was initially considered, but the diagnosis of Takotsubo cardiomyopathy associated with thyroid storm was ultimately made based on cardiac catheterization and laboratory investigation.All authors: Burman KD, Choudhary C, El-Maouche D, Eliades M, Zinsmeister BDigital Object Identifier: Date added to catalog: 2014-11-11
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Journal Article MedStar Authors Catalog Article Available 23560557

Available online from MWHC library: August 2000 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Takotsubo or stress-induced cardiomyopathy is a form of reversible cardiomyopathy commonly associated with emotional or physical stress. Thyrotoxicosis has been identified as a rare cause of Takotsubo cardiomyopathy, with only 12 cases reported in the literature. Here, we report a case of thyroid storm presenting with Takotsubo cardiomyopathy in the setting of Graves' disease.

CONCLUSIONS: Thyrotoxicosis is associated with adverse disturbances in the cardiovascular system. Takotsubo cardiomyopathy could be a presenting manifestation of thyroid storm, perhaps related to excess catecholamine levels or sensitivity.

PATIENT FINDINGS: A 71-year-old woman presented with abdominal pain, vomiting, confusion, and history of weight loss. She was initially diagnosed and treated for diabetic ketoacidosis at another hospital and was transferred to our hospital one day after initial presentation because of concern for acute coronary syndrome. A diagnosis of Takotsubo cardiomyopathy was made on the basis of cardiac catheterization. At that time, she was diagnosed and treated for thyroid storm. Follow-up 7 weeks later revealed improvement of her cardiac function and near-normalization of thyroid hormone levels.

SUMMARY: In this patient, who presented with symptoms of heart failure, acute coronary syndrome was initially considered, but the diagnosis of Takotsubo cardiomyopathy associated with thyroid storm was ultimately made based on cardiac catheterization and laboratory investigation.

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