갑상샘항진증에서 우심부전을 동반한 중증 삼첨판 폐쇄부전증 1예
Reversible severe tricuspid regurgitation with right heart failure associated with thyrotoxicosis
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초록
결론적으로 갑상샘항진증과 연관된 좌심부전의 소견이 없이 우심부전을 동반한 삼첨판 폐쇄 부전증을 보였던 예에서 항갑상샘제제 및 소량의 이뇨제 치료로 호전되었다. 폐동맥 고혈압을 동반한 우심부전과 삼첨판 폐쇄부전이 있을 경우 갑상샘항진증은 이의 가능한 원인으로서 고려되어야 한다.
Abstract
Left-sided heart failure can be complicated in the patient suffering with thyrotoxicosis; however, predominantly right heart failure in thyrotoxic patients is a rare condition. We present here a case of reversible right-heart failure with severe tricuspid regurgitation associated with thyrotoxicosis. A 71-year-old woman was admitted to the hospital because of a 10-day history of shortness of breath and indigestion. On echocardiography, there was a normal-sized left ventricle with preserved systolic and diastolic function. However, the right atrium and ventricle were dilated, and there was incomplete systolic coaptation of the tricuspid leaflets, resulted in severe tricuspid regurgitation. The maximal velocity of tricuspid regurgitation was 3.7 m/sec and the estimated pressure gradient between the right two chambers was 55 mmHg. After treatment that included diuretics and antithyroid drug (methimazole), the symptoms of right heart failure resolved. Four weeks later, a second echocardiogram was obtained revealing a normalized right atrium and ventricle, trivial tricuspid regurgitation and the resting pulmonary hypertension had disappeared.(Korean J Med 73:206-209, 2007)
참고문헌 (10)
- Klein I, "Thyrotoxicosis and the heart", Endocrinol Metab Clin North Am, 27, pp.51~62 (1998)
- Cohen J, "Right heart failure and hyperthyroidism: a neglected presentation", Am J Med, 115, pp.76~77 (2003)
- Waller BF, "Pathology of tricuspid valve stenosis and pure tricuspid regurgitation: part II", Clin Cardiol, 18, pp.167~174 (1995)
- Dougherty MJ, "Apathetic hyperthyroidism presenting as tricuspid regurgitation", Chest, 63, pp.767~772 (1973)
- Xenopoulos NP, "Severe right heart failure in a patient with Grave'sdisease", Clin Cardiol, 19, pp.903~905 (1996)
- Okura H, "High-output heart failure as a cause of pulmonary hypertension", Intern Med, 33, pp.363~365 (1994)
- 박형서, "Thiamine 결핍에 의해 발생한 가역적인 중증 폐동맥 고혈압증 1예", 대한내과학회지 (비 출간 자료)
- Nakchbandi IA, "Pulmonary hypertension caused by Graves' thyrotoxicosis: normal pulmonary hemodynamics restored by (131)I treatment", Chest, 116, pp.1483~1485 (1999)
- Whitner TE, "Hyperthyroidism presenting as isolated tricuspid regurgitation and right heart failure", Tex Heart Inst J, 32, pp.244~245 (2005)
- Paran Y, "Pulmonary hypertension and predominant right heart failure in thyrotoxicosis", Resuscitation, 69, pp.339~341 (2006)