Management of Thyrotoxicosis and its Associated Atrial Fibrillation- A Case Report

ABSTRACT

Background: Thyrotoxicosis is a condition occurs when excessive thyroid hormone level produced by overactive thyroid gland. It is the risk factor of getting atrial fibrillation (AF) as it could exert marked influences on electrical impulse generation and conduction which associated with shortening of action potential duration and contribute to AF. Case: A 57 years old Chinese female was diagnosed with thyrotoxicosis and atrial fibrillation when she was admitted to emergency department of hospital with complaints of shortness of breath, dyskinesia, on and off palpitation, fine tremor, tachycardia, warm skin, firm, enlarged and palpable thyroid, having patches of vitiligo on hands and feet and increase bowel movement. The CT scan has revealed small infarct near left band ganglia. Aims: The aims of management in this case were to resolve the symptoms presented and get the thyroid hormone levels restored to euthyroid state. Results: Aspirin and propranolol were given immediately after diagnosis for symptomatic relieve and rate control. Carbimazole and dexamethasone were given concurrently for hyperthyroid management. Aspirin was then replaced by warfarin before patient discharged to have better control and reduce risk of stroke. Furthermore, the patient’s ECG and INR were monitored closely for stroke prevention.

KEYWORDS

• Antithyroid drugs
• Atrial fibrillation
• Hyperthyroidism
• Stroke prevention
• Thyrotoxicosis

Showing references and in-text citations exactly as published.

• DOI10.5530/jyp.2017.9.117Copy

RELATED ARTICLES

Matched on section and article type within this issue of JYP.

• Article · VOLUME 9, ISSUE 4Optimization of Ionic Liquid-Based Microwave Assisted Extraction to Obtain Trans-resveratrol from Gnetum gnemon L. SeedsImalia Nurachma Ayuningtyas, Maesya Rahmawati, Sutriyo s, Abdul Mun’im · pp. 457–462Same type: Article
• Article · VOLUME 9, ISSUE 4The Antifungal Effect of some 4-Chloro-6-Methoxy-N, N-Dimethylpyrimidin-2-Amine Derivatives Containing a Heterocyclic Compound on the Important types of FungiNadhir N.A. Jafar, Ibtihial M Abdul Mahdi, Mahmoud Hussein Hadwan, Ameer A, Alameri · pp. 463–467Same type: Article
• Article · VOLUME 9, ISSUE 4Antifungal Effect of Kaffir Lime Leaf Extract on Selected Fungal Species of Pathogenic Otomycosis in in vitro Culture MediumMohd Syafwan Soffian, Irfan Mohamad, Zeehaida Mohamed, Rosdan Salim · pp. 468–474Same type: Article
• Article · VOLUME 9, ISSUE 4Computational Study of Bufadienolides from Indonesia’s Kalanchoe pinnata as Na+/K+-ATPase Inhibitor for Anticancer AgentMuhammad Yusuf, Ade Rizqi Ridwan Firdaus, Unang Supratman · pp. 475–479Same type: Article