Early literature presented conflicting evidence regarding the prevalence and existence of myxedema heart and associated heart failure symptoms in hypothyroid patients.
Conflicting historical reports on myxedema heart warrant clinical caution in hypothyroidism; leaves open its prevalence and modern validation.
Since Zondek 1 first reported myxedema heart in 1918 there has been an increasing number of cases recorded. In 1925 Fahr 2 could find but eight cases with roentgenologic and electrocardiographic studies. At that time he described three cases that he had seen during the past year, one of which was reported in detail and two in outline. In 1932 he 3 described the further progress of one of the preceding cases and reported five additional cases that he had seen in the preceding eight years. Of seventeen cases of severe and moderately severe myxedema, thirteen showed signs and symptoms of heart failure, of which five were severe. Willius and Haines 4 in 1925 referred to Fahr's first paper and reported a study of 162 cases of high grade myxedema without finding a single characteristic case of myxedema heart. One hundred and forty-eight (91 per cent) were free of subjective or objective signs of
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William H. Allen (1937) studied this question.
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