[Hypothyroidism and coronary artery bypass surgery]

A hypothyroid patient with severe coronary disease is described. Coronary artery bypass was undertaken without preoperative treatment with thyroid hormone. Coronary artery bypass surgery may be undertaken in hypothyroid patients without significant risks. As a rule, preoperative administration of thyroid hormone should be omitted on account of the risk of aggravating the ischaemic cardiac condition. Treatment with L-thyroxin is instituted rapidly postoperatively and, in the great majority of cases, it is possible to obtain complete thyroid hormone substitution therapy after coronary revascularisation has been performed. It is emphasized that all middle-aged women with raised serum cholesterol should be screened for myxoedema even if they do not appear to be hypothyroid clinically.