Drug-resistant Graves' disease complicated by hypertension and heart failure: a case report and literature review
DOI:
https://doi.org/10.82127/79tqcc57Keywords:
thyroid disease,cardiac failure,thyroidectomyAbstract
BACKGROUND: Thyrocardiac disease,a severe complication of hyperthyroidism,can lead to life threatening cardiac manifestations such as congestive cardiac failure,arrhythmias and pulmonary hypertension.While most patients respond to medical treatment, a subset remain refractory necessitating alternative interventions.
CASE PRESENTATION: A 37-year old female caterer presented with an 11-month history of weight loss,palpitations and fatigue.Clinical and laboratory findings confirmed thyrotoxicosis and Class IV congestive heart failure.Despite maximal medical therapy with carbimazole,beta blockers,diuretics and other medications her symptoms persisted with recurrent cardiac failure.She under went right total and left subtotal thyroidectomy complicated by post-operative supraventicular tachycardia and acute pulmonary oedema requiring oxygen therapy,intravenous diuretics and management in the intensive care unit.
By the 8th post-operative day she was stable and was discharged on the 10th post-operative day.At 3 month follow-up thyroid function and cardiac parameters were normal.
CONCLUSION: This case highlights the challenges of managing treatment refractory thyrocardiac disease in a resource constrained environment and underscores the importance of early surgical intervention. A multidisciplinary approach is critical for optimizing outcomes in this high risk population.
