DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162345

Graves’ disease presenting as right heart failure with severe pulmonary hypertension

Furqan Mohd Akram Khan, Anannya Mukherji, Shekhar T. Nabar, Ashwini G

Abstract


We report a patient who presented to our institution with clinical features of right sided heart failure and hyperthyroidism. Diagnosis of grave’s disease induced reversible severe pulmonary hypertension leading to severe tricuspid regurgitation and right sided heart failure was made after all the common causes were ruled out using the biochemical and radiological investigations and review of literature. Graves' disease is a common cause hyperthyroidism, is an immune system disorder that results in the overproduction of thyroid hormones.


Keywords


Graves’ disease, Hyperthyroidism, Heart failure, Tricuspid regurgitation, Pulmonary hypertension

Full Text:

PDF

References


Ellis H. Robert Graves: 1796-1852. Br J Hosp Med (Lond). 2006;67(6):313.

Noheria A, Khanna S, West CP. 37-year-old woman with palpitations and fatigue. Mayo Clin Proc. 2011;86:75-8.

Shimazaki M, Mitsuhashi T, Hasegawa K. Idiopathic pulmonary hypertension associated with hyperthyroidism: an autopsy case (in Japanese). Nippon Rinsho. 1980;38(3):1783-6.

Virani SS, Mendoza CE, Ferreira AC, De Marchena E, Graves' disease and pulmonary hypertension: report of 2 cases. Texas Heart Institute Journal. 2003;30(4):314-5.

Suk JH, Cho KI, S. H. Lee, et al., “Prevalence of echocardiographic criteria for the diagnosis of pulmonary hypertension in patients with Grave’s disease: before and after antithyroid treatment. Journal of Endocrinological Investigation. 2011;34(8):229-34.

Nakchbandi IA, Wirth JA, Inzucchi SE. Pulmonary hypertension caused by Graves’ thyrotoxocosis: normal pulmonary hemodynamics restored by iodine 131 treatment. Chest. 1999;116:1483-5.

Soroush-Yari A, Burstein S, Hoo GW, Santiago SM. Pulmonary hypertension in men with thyrotoxicosis. Respiration. 2005;72:90-4.

Arroliga A, Dweik RA, Rafanan A. Primary pulmonary hypertension and thyroid disease (letter to the editor). Chest. 2000;118:1224.

Nakchbandi IA, Wirth JA, Inzucchi SE. Pulmonary hypertension caused by graves' thyrotoxicosis: normal pulmonary hemodynamics restored by 131I treatment. Chest. 1999;116(5):1483-5.

Paran Y, Nimrod A, Goldin Y. Pulmonary hypertension and predominant right heart failure in thyrotoxicosis. Resuscitation. 2006;69:339-41.

Whitner TE, Hudson CJ, Smith TD. Hyperthyroidism presenting as isolated tricuspid regurgitation and right heart failure. Tex Heart Inst J. 2005;32:244-5.

Lozano HF, Sharma CN. Reversible pulmonary hypertension, tricuspid regurgitation, and right-sided heart failure associated with hyperthyroidism. Cardiol Rev. 2004;12:299-305.

Marvisi M, Brianti M, Marani G. Hyperthyroidism and pulmonary hypertension. Respir Med. 2002;96:215-20.

Okada M, Ota T, Okura H, et al. Pulmonary hypertension associated with refractory hyperthyroidism: a case report. J Cardiol. 2001;37:277-83.

Mozo Herrera G, Fernandez Gonzalez MJ, Salgado Blanco J, et al. Hyperthyroidism, jaundice, and pulmonary hypertension. Ann Med Intern. 2001;18:262-4.

Nduwayo L, Pop C, Heim J. Reversible pulmonary hypertension in Basedow’s disease. Presse Med. 2000;29:2216-2218.

Nakchbandi IA, Wirth JA, Inzucchi SE. Pulmonary hypertension caused by Graves’ thyrotoxocosis: normal pulmonary hemodynamics restored by iodine131 treatment. Chest. 1999;116:1483-5.

Thurnheer R, Jenni R, Russi EW. Hyperthyroidism and pulmonary hypertension. J Intern Med. 1997;242:185-88.

O’Donovan D, McMahon C, Costigan C. Reversible pulmonary hypertension in neonatal Graves’ disease. Ir Med J. 1997;90:147-8.

Iranzo Vázquez D, Rius Riu F, Pizarro Lozano E, Lupón Roses J. Severe tricuspid regurgitation as the main manifestation of hyperthyroidism. Rev Esp Cardiol. 1997;50:65-6.

Agraou B, Tricot O, Strecker A, Bresson R, Leroy F, Langlois P. Hyperthyroidism associated with pulmonary hypertension. Arch Mal Coeur Vaiss. 1996;89:765-8.

Xenopoulos N, Braden GA, Applegate RJ. Severe right heart failure in a patient with Graves’ disease. Clin Cardiol. 1996;19:903-5.

Alcazar R, Rey M, de Sequera P. Reversibility of pulmonary hypertension associated with autoimmune hyperthyroidism. Rev Esp Cardiol. 1995;48:142-4.

Okura H, takatsu Y. High-output heart failure as a cause of pulmonary hypertension. Intern Med. 1994;33:363-5.

Kage K, Kira Y, Sekine I, et al. High incidence of mitral and tricuspid regurgitation in patients with Graves’ disease detected by two-dimensional color Doppler echocardiography. Intern Med. 1993;32:374-6.

Martos VJ. Primary pulmonary hypertension associated with hyperthyroidism. Aten Primaria. 1992;9:163-4.

Dougherty MJ, Craige E. Apathetic hyperthyroidism presenting as tricuspid regurgitation. Chest. 1973;63:767-72.

Paran Y, Nimrod A, Goldin Y, Justo D. Pulmonary hypertension and predominant right heart failure in thyrotoxicosis. Resuscitation. 2006;69:339-41.

Mercé J1, Ferrás S, Oltra C, Sanz E, Vendrell J, Simón I. Cardiovascular abnormalities in hyperthyroidism: a prospective Doppler echocardiographic study. Am J Med. 2005;118:126-31.

Marvisi M, Zambrelli P, Brianti M, Civardi G, Lampugnani R, Delsignore R. Pulmonary hypertension is frequent in hyperthyroidism and normalizes after therapy. European Journal of Internal Medicine. 2006;17(4):267-71.

Armigliato M, Paolini R, Aggio S, Zamboni S, Galasso MP, Zonzin P, Cella G. Hyperthyroidism as a cause of pulmonary arterial hypertension: a prospective study. Angiology. 2006;57:600-6.