INTRACTABLE PAROXYSMAL TACHYCARDIA IN THYROTOXICOSIS SIMULATING MYOCARDIAL INFARCTION
| Autor: | Jørgen G. Jacobsen, K. Lyngborg |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Paroxysmal tachycardia Tachycardia Cardiac Catheterization Digoxin medicine.medical_specialty Myocardial Infarction Infarction Procainamide Ventricular tachycardia Hyperthyroidism Angina Pectoris Diagnosis Differential Electrocardiography Internal medicine Atrial Fibrillation Bradycardia Internal Medicine medicine Humans cardiovascular diseases Myocardial infarction Diagnostic Errors Tachycardia Paroxysmal medicine.diagnostic_test business.industry Lidocaine Atrial fibrillation Middle Aged medicine.disease Thyroxine Anesthesia cardiovascular system Cardiology medicine.symptom business medicine.drug |
| Zdroj: | Acta Medica Scandinavica. 192:427-431 |
| ISSN: | 0001-6101 |
| Popis: | The case of a 59-year-old man, admitted to hospital because of precordial pain indicating acute myocardial infarction (AMI), is presented. ECG showed evidence of posterior wall infarction. The subsequent course was characterized by a variety of cardiac arrhythmias, notably atrial fibrillation, treated with digoxin and for a short time with a β-blocking agent, and premature ventricular beats and short runs of ventricular tachycardia, treated with lidocain and procainamide. Transient bradycardia and A-V dissociation caused the patient to be transferred to a coronary care unit to have a cardiac catheter inserted. Four weeks after the acute episode intractable ventricular tachycardia caused the patient's death. At autopsy no evidence of AMI was found. Thyroxin levels in the plasma, reported post mortem, were in the hyperthyroid range. In retrospect evidence of masked thyrotoxicosis could be discerned. The occurrence of angina pectoris, atrial fibrillation and other more unusual cardiac arrhythmias in thyrotoxicosis are discussed. No previous report of thyroid hormone-induced fatal ventricular tachycardia appears to have been published. It is emphasized that the diagnosis of thyrotoxicosis should be considered in all less characteristic cases of cardiac arrhythmia, despite the concomitant presence of cardiac pain suggesting myocardial infarction. |
| Databáze: | OpenAIRE |
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