Endocrine Abstracts

Cardiothyreosis (CT) is defined as an association of hyperthyroidism (HT) with severe heart complications such as rhythmic troubles, heart and/or coronary insufficiency. Recently ventricle-auricular block and arterial pulmonary hypertension (APHT) was added to the definition. CT is the most frequent and one of the most dangerous complications of hyperthyroidism (HT) in emerging countries compared to developed countries where this abnormality is deemed to be very rare. Our aim was to study its frequency, analyze its profile and response to radical treatment in 63 men with cardiothyreosis.

Subjects and methods: It is a retro- and prospective study (1981–2011) which took into account medical history, clinical examination, routine analyses, hormonal and heart explorations based on echosonography, electro radiography±heart MRI and heart scintigraphy.

Results: Among 447 male HT, 63 had CT=14%. We observed 3.1cases/year. Mean age at diagnosis=50.76 years (26–83). 7 (12%) were ≤30 years old. 90% were diagnosed because of rhythmic troubles. A history of heart disease was noted in 70%. Auricular fibrillation was found in 100%, heart insufficiency in 36%, APHT in 12%, and dilated cardiomyopathy in 36%. Glucose metabolism abnormalities were associated in 18%. After radical treatment (surgery or radio iodine) heart problems disappeared in 80%.

Conclusion: CT is very frequent in our population (14%). It is observed in middle age or old people, especially those with an antecedent of heart problems. Radical treatment leads to a good prognosis except when there is a dilated cardiomyopathy. The best treatment is prevention of rheumatic diseases and precocious diagnosis of HT.