Features of the course of diffuse toxic goiter in elderly patients

Abstract

Diffuse toxic goiter is one of the frequent endocrine pathologies that lead to damage to the cardiovascular system. The prevalence of thyrotoxicosis in people over 65 years of age is 15%. The clinic of thyrotoxicosis among elderly patients is nonspecific and asymptomatic. Asthenic symptoms prevail – increasing muscle weakness, weight loss, neurological symptoms, expressed in lethargy and depression, changes in the gastrointestinal tract, cardiovascular system. Elderly patients often have tachycardia, atrial fibrillation, atrial fibrillation, increasing heart failure, which is associated with age-related changes in the myocardium, concomitant atherosclerosis-associated diseases. Atrial fibrillation in patients with thyrotoxicosis increases the risk of thromboembolic complications. Low-symptomatic manifestations of thyrotoxicosis require a more thorough examination, including laboratory, hormonal and instrumental methods. This article considers a clinical case of an elderly patient with diffuse toxic goiter. The features of the clinical picture with the predominance of disorders from the cardiovascular system -interruptions in the work of the heart, increased shortness of breath, signs of increasing cardiovascular insufficiency are presented. Diagnostic studies, differential diagnostic search, confirming the presence of thyrotoxicosis and cardiovascular insufficiency were conducted. Appropriate treatment has been prescribed. An integrated approach in the treatment of patients with diffuse toxic goiter in combination with ischemic heart disease significantly improves the condition of patients, normalizes the thyrotoxic status, and, consequently, the state of the cardiovascular system against the background of the use of thyrostatics. Also, the wellbeing of patients improves because of correction of cardioprotective therapy, the heart rate is normalized, the signs of chronic heart failure are significantly compensated.