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Dilated cardiomyopathy in thyrotoxicosis
  1. S Goland,
  2. S Shimoni,
  3. O Kracoff
  1. Department of Internal Medicine C and Institute of Cardiology, Kaplan Hospital, 76100 Rehovot, Israel
  1. Dr Goland.

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Heart failure is a rare manifestation of thyrotoxicosis in patients without heart disease.1-3 We report two cases of thyrotoxicosis and no previous heart disease presenting with severe heart failure. Successful treatment of the thyrotoxicosis resulted in progressive improvement of cardiac function.

Case 1

A 31 year old woman was admitted with pulmonary oedema. Two months earlier she had complained of fatigue, palpitation, and chest discomfort. She had no risk factors for coronary artery disease, had regular menses, and denied smoking or alcohol consumption. There were no symptoms of intercurrent infection.

On physical examination she looked very ill. Her heart rate was 120 beats/min and blood pressure 130/80 mm Hg. She had a small goiter and typical signs of thyrotoxicosis including warm, moist skin and a fine tremor. There was an audible S3 on cardiac …

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