甲狀腺機能亢進併發右心衰竭合併三尖瓣迴流

Severe Tricuspid Regurgitation Complicated by Right Heart Dysfunction in Patient with Hyperthyriodism

董文慶(Wen-Ching Doong) ； 楊世平(Shih-Ping Yang) ； 丁予安(Yu-An Ding)

《Journal of Medical Sciences》 11卷5期 (1991/10) Pp. 361-366

摘要

甲狀腺素具有直接刺激心臟收縮和增快心跳遠率的作用，但詳細機轉未明。目前甲狀腺機能亢進所造成的心衰竭患者，大多見於老年人，雖然那有先前未曾罹患心臟病而有心衰竭的病倒報導，但屬罕見。三軍總醫院自1987年至1989年間，一共收集了8例甲狀腺機能亢進病患，其主訴包括呼吸困難及下肢水腫、心悸甚至昏厥；而實驗診斷則發現右心功能障礙合併嚴重三尖瓣迴流。經投予抗甲狀腺藥物、乙型阻斷劑、利尿劑及洋地黃等藥物治療後，上述徵侯呈現可逆性之改善。在此，我們藉文獻之回顧，希望有助於醫師之臨床判斷及處理此類病人。

關鍵字

甲狀腺機能亢進 ； 三尖瓣迴流 ； 右心衰竭

並列摘要

Thyroid hormone have a direct positive chronotropic and inotropic effect on the heart. However, the mechanisms are still uncertain. Congestive heart failure without preexisting heart disease has been occasionally reported, but is very rare. This finding is probably more pronounced in elderly patients. From Tri-Service General Hospital between Feb 1987 to July 1989, we collected eight cases of hyperthyroidism with the chief complaints of shortness of breath and swelling of legs, or palpitation and syncope, and laboratory findings of right heart dysfunction and severe tricuspid regurgitation. After treatment of anti-thyroid drugs, B-blockade, diuretics and digoxin, the tricuspid regurgitation and right heart dysfunction presented reversible improvement. Herein, we also want to make literatures review to contribute clinical judgement and management.

並列關鍵字

Hyperthyroidism ； Tricuspid regurgitation ； Rigth heart dysfunction