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[Hypothyroidism and coronary artery bypass surgery]
Insights
Hypothyroid patients with severe coronary disease can undergo coronary artery bypass surgery safely. Preoperative thyroid hormone treatment is generally avoided to prevent cardiac risks, with rapid postoperative hormone replacement.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Hypothyroidism poses risks in patients with severe coronary artery disease.
- Management strategies for hypothyroid patients undergoing cardiac surgery are crucial.
Observation:
- A case of coronary artery bypass surgery in a hypothyroid patient without preoperative thyroid hormone treatment is presented.
- The patient had severe coronary disease.
Findings:
- Coronary artery bypass surgery can be performed on hypothyroid patients without significant risk.
- Omitting preoperative thyroid hormone administration is recommended to avoid exacerbating cardiac conditions.
- Postoperative L-thyroxine treatment allows for rapid and complete thyroid hormone substitution.
Implications:
- Screening middle-aged women with high cholesterol for myxedema is advised, even without apparent clinical hypothyroidism.
- This approach ensures safer surgical outcomes for hypothyroid patients with coronary disease.
- Early detection and management of hypothyroidism can prevent cardiac complications.
Abstract:
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.