Recurrent atrial fibrillation with fast ventricular rate in an elderly lady: old records reveal cause of the malady

Authors

  • Punam Bhende Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India https://orcid.org/0000-0003-2694-8126
  • Jyoti Mannari Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Rishikesh Wagh Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Vrajesh Parikh Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Rahul Talavia Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Naman Patel Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Ramesh Chaudhary Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Mansi Patel Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India
  • Mehul Rathod Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250270

Keywords:

AIT, Amiodarone, Thyrotoxicosis, Atrial fibrillation

Abstract

Amiodarone is an iodinated benzofuran derivative and is prescribed widely in management of arrythmias- ventricular and supraventricular alike. Excellent efficacy, minimal negative inotropic activity and less rate of ventricular pro arrhythmia makes it the choice of drug in heart failure. Side effects however, make it a drug to be used with caution and they range from pulmonary toxicity to thyroid dysfunction. 15-20% of patients treated with amiodarone are believed to develop some thyroid dysfunction. It can cause amiodarone induced hypothyroidism (AIH) or amiodarone induced thyrotoxicosis (AIT). AIT usually is seen in areas with low uptake of iodine and AIH in areas with sufficient iodine uptake. We report a case of 58-year-old lady with rheumatic heart disease who was started on amiodarone for atrial fibrillation and later presented with recurrent atrial fibrillation (AF) with fast ventricular rate (FVR) and diagnosed as AIT. The challenges in diagnosis and management are discussed.

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Author Biographies

Punam Bhende, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Associate Professor

Department of Medicine

Jyoti Mannari, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Professor

Department of Medicine

Rishikesh Wagh, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Junior Resident

Department of Medicine

Vrajesh Parikh, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Junior Resident

Department of Medicine

Rahul Talavia, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Junior Resident 

Department of Medicine

Naman Patel, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Junior Resident

Department of Medicine

Ramesh Chaudhary, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Junior Resident 

Department of Medicine

Mansi Patel, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Senior Resident

Department of Medicine

Mehul Rathod, Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India

Senior Resident

Department of Medicine

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Published

2025-01-30

How to Cite

Bhende, P., Mannari, J., Wagh, R., Parikh, V., Talavia, R., Patel, N., Chaudhary, R., Patel, M., & Rathod, M. (2025). Recurrent atrial fibrillation with fast ventricular rate in an elderly lady: old records reveal cause of the malady. International Journal of Research in Medical Sciences, 13(2), 863–866. https://doi.org/10.18203/2320-6012.ijrms20250270

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Section

Case Reports