Endocrine Abstracts (2017) 49 EP1232 | DOI: 10.1530/endoabs.49.EP1232

Clinical aspects of cardiothyreosis in patients with Graves' disease

Rym Belaid, Ibtissem Oueslati, Wafa Mimita, Nadia Mchirgui, Karima Khiari & Néjib Ben Abdallah

Department of Endocrinology, Charles Nicolle Hospital, Tunis, Tunisia.

Introduction: Cardiothyreosis (CT) is the most frequent and dangerous complication of hyperthyroidism (HT). It is defined as an association of HT with severe heart abnormalities such as: rhythmic troubles, heart and/or coronary insufficiency. The aim of our study was to describe the frequency and the clinical characteristics of CT in Graves’ disease (GD).

Methods: Patients with GD were enrolled into a retrospective study. The prevalence and the clinical characteristics of CT were described.

Results: Out of 90 participants with GD, 12.2% patients presented with cardiothyreosis. Their sex ratio (M/F) was 9/2 and their mean age was 46.72±15.11 years. CT was the circumstance of discovery of GD in 2.2% of cases. Its clinical manifestations were palpitation in 75.5%; dyspnea in 24.4% and anginal pain in 5.6%. Different modes of presentation of CT were found: ten cases of atrial fibrillation (ACFA) (90.9%); five cases of Heart failure (45.45%) and three cases of coronary insufficiency (27.27%). Systolic blood pressure was on average 128±11.6 mmHg and mean diastolic blood pressure was 76±19 mmHg. Mean heart frequency was measured at 106±20 beats/min. Underlying mitral valvulopathy was found in two cases. Six out of 11 patients presented anemia (54.5%) and 90.9% had severe hyperthyroidism. Arrhythmia was reduced in 72.7% of the cases, after treating with betablocker.

Conclusion: CT, although rare, remains a serious life-threatening complication of GD. The ACFA is its most common clinical form and underlying cardiac disease is often present.

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