Korean J Med.  2007 Aug;73(2):206-209.

Reversible severe tricuspid regurgitation with right heart failure associated with thyrotoxicosis

• Jang WI
• Kim EM
• Ahn KT
• Park JH
• Choi SW

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.

Keyword

Thyrotoxicosis; Heart failure; Ventricle; Right; Tricuspid regurgitation

MeSH Terms

Aged
Diuretics
Dyspepsia
Dyspnea
Echocardiography
Female
Heart Atria
Heart Failure*
Heart Ventricles
Heart*
Humans
Hypertension, Pulmonary
Thyrotoxicosis*
Tricuspid Valve Insufficiency*
Diuretics