Why the study?
Cardiac arrhythmias, cardiac ischemia, and cardiomyopathy associated with Graves' disease are rare in young adults without a history of heart disease.
Uncontrolled Graves' disease can lead to severe but potentially reversible heart failure and arrhythmias in young adults, highlighting the need for early definitive treatment.
Prolonged uncontrolled Graves' disease warrants cardiac vigilance in young adults; leaves open whether early control prevents cardiomyopathy.
Graves' disease is associated with cardiac arrhythmias especially in the suprventricular stage, cardiac ischemia and cardiomyopathy - all rare in young adults without a history of heart disease. We present two young individuals who developed cardiac complications after periods of uncontrolled Graves' disease. Subject 1: A 51-year-old woman, thyrotoxic for several months, developed atrial fibrillation (AF) and heart failure. Echocardiography showed cardiomegaly - EF 30%. It maintains sinus rhythm after early total thyroidectomy (EF 50%). Subject 2: A 21 year old man developed thyrotoxic symptoms One month after starting carbimazole; he developed acute heart failure (HF) due to severe dilated cardiomyopathy - 15-20% LVEF. He partially recovered after treatment - 28% LVEF and had early treatment for his dysthyroidism. Significant heart complications can occur in previously physically fit young adults who have had Graves’ disease that have not been controlled for weeks or even months. The majority of heart function is restored, but early definitive treatment should be discussed to prevent relapse of Graves' disease and other heart conditions.
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Camara et al. (2023) studied this question.
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