UNLABELLED: 45 patients with hyper and hypothyroidism in the time 1989-1990 were observed. The Graves' disease was diagnosed in 29 and rather in the younger patients, but 16 had the toxic nodular goiter and those were elderly. In 27 the hypertension was secondary (symptomatic) and after the successful treatment of the hyperthyroidism was completely controlled. In 14 cases the hypertension was primary (essential) and the application of the hypotensive drugs was also necessary. Among 4 patients with primary hypothyroidism and associated hypertension and coronary insufficiency the early treatment by the thyroid preparation was successful: the blood pressure was lowered and the coronary insufficiency was improved; but if the replacement therapy was stopped and the hypothyroidism was relapsed, the blood pressure was increases and the coronary insufficiency was aggravated. CONCLUSIONS: 1. The secondary (symptomatic) hypertension associated with the hyperthyroidism may be controlled by successful treatment of the thyrotoxicosis, but the primary (essential) must be treated by the hypotensive drugs also. 2. The early treatment of the hypothyroidism may control the associated hypertension and the coronary insufficiency. 3. Graves' disease is associated mostly with symptomatic hypertension, in nodular toxic goiter in most of the cases the essential hypertension was established.

Adult↗

PubMedDate not supplied

[Current diagnosis and treatment of cardiac arrhythmias of thyroid origin].

Cardiac arrhythmias may often be of the thyroid origin. It is so-called thyroid-cardiac syndrome which may also be manifested by the circulatory failure and angina pectoris. The authors have been observed 54 cases of such arrhythmias; they have frequently been manifested by the paroxysmal tachycardia, extrasystolic beats, and paroxysmal or stable atrial fibrillation. Diagnosis of such arrhythmias may be difficult in case of the masked hyperthyroidism being its only clinical symptom. In order to establish a proper diagnosis the following tests of thyroid gland functioning have been carried out: TRH-TSH, scintigraphy and ultrasound examination of the thyroid gland. TRH-TSH test enables to detect disorders of hypophyseal-thyroidal regulation characteristic for both overt and masked hyperthyroidism. Scintigraphic examination reveals autonomic nodules of the thyroid glands being frequently a cause of cardiac arrhythmias. Ultrasound examination enables confirmation of the diagnosed autonomic thyroid nodules without TSH test. In the majority of cases of cardiac arrhythmias therapy with radioactive iodine isotope was introduced. Some patients with appropriate indications have been treated surgically after proper preparation. Pharmacological treatment in thyroid-cardiac syndrome produces transient and instable result.

Adult↗

PubMedDate not supplied

[Inappropriate indication for surgical treatment of goiter diagnosed as hyperactive].

Aim of this report is a stress of over-hasty classification to the surgical treatment of goiter diagnosed as hyperactive. The authors suppose that the cause of such errors is an incorrect interpretation of the current diagnostic tests, especially scintigraphy, and not very careful clinical evaluation of cases diagnosed as hyperthyroidism, being vegetative neurosis which is sometimes accompanied by the arterial blood hypertension. Examples of patients misclassified from the surgical treatment after proper diagnosis based on the clinical symptoms confirmed with thyroid gland diagnostic test are given. The authors stress that the detailed knowledge on the clinical course of hyperthyroidism and proper interpretation of the diagnostic tests help to avoid such errors.

Adult↗

PubMedDate not supplied