Abstract
The article describes a clinical case of the occurrence of complex disorders of the heart rhythm and conductivity in a patient of 45 years with decompensated hypothyroidism. The literature data on specific cardiomyopathy appearing in patients with hypothyroidism (“hypothyroid heart”), metabolic, hemodynamic changes against the background of hypothyroidism and possible violations of heart rhythm and conductivity are given. In the described clinical case the patient’s medical history is given, who has been observed in an endocrinologist for hypothyroidism for the last 3 years. 6 months before this hospitalization patient stopped taking levothyroxine on her own initiative. She noticed deterioration in the last 3 months: the clinic of hypothyroidism appeared and began to grow, a frequent extrasystole appeared. At an objective survey — a symptomatology of the expressed hypothyroidism. A comprehensive examination of the patient was performed, which revealed atrioventricular blockade of the 1st degree, frequent ventricular extrasystole, prolongation of the QT interval on the ECG, late ventricular potentials against the background of low concentrations of sodium and potassium in the blood. During the first 24 hours of hospitalization, there was a clinical death. A clear positive dynamics was traced against the background of therapy aimed at the correction of electrolyte disorders, as well as hormone replacement therapy with levothyroxine.
Highlights
In the described clinical case the patient’s medical history is given, who has been observed in an endocrinologist for hypothyroidism for the last 3 years. 6 months before this hospitalization patient stopped taking levothyroxine on her own initiative
A clear positive dynamics was traced against the background of therapy aimed at the correction of electrolyte disorders, as well as hormone replacement therapy with levothyroxine
Самый частый вид аритмии при гипотиреозе — синусовая брадикардия, которую выявляют у 30-60% больных
Summary
2 — Государственное бюджетное учреждение здравоохранения «Оренбургская областная клиническая больница» (ГБУЗ «ООКБ»), Оренбург, Россия. СЛОЖНЫЕ НАРУШЕНИЯ РИТМА И ПРОВОДИМОСТИ СЕРДЦА У ПАЦИЕНТКИ С ГИПОТИРЕОЗОМ (КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ). COMPLEX DISORDERS OF HEART RHYTHM AND CONDUCTIVITY IN A PATIENT WITH HYPOTHYROIDISM (CLINICAL OBSERVATION). В статье описан клинический случай возникновения сложных нарушений ритма и проводимости сердца у пациентки 45 лет с декомпенсированным гипотиреозом. Приведены данные литературы о специфической кардиомиопатии, возникающей у пациентов с гипотиреозом, именуемой «гипотиреоидным сердцем», метаболических, гемодинамических изменениях на фоне гипотиреоза и возможных нарушениях ритма и проводимости сердца. В описанном клиническом примере дана история болезни пациентки, которая в течение последних 3 лет наблюдалась у эндокринолога по поводу гипотиреоза. Ключевые слова: аутоиммунный тиреоидит, гипотиреоз, гипотиреоидное сердце, нарушения ритма сердца Для цитирования: Козлова Л.К., Кучма Г.Б., Турмухамбетова Б.Т., Ибрагимова Е.А., Соколова Н.В., Шатилов А.П. РИТМА И ПРОВОДИМОСТИ СЕРДЦА У ПАЦИЕНТКИ С ГИПОТИРЕОЗОМ (КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ).
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