Rheumatic heart disease and thyroid status

A retrospective analysis of 76 patients with rheumatic heart disease revealed nine with thyrotoxicosis, three with hypothyroidism and seven with normal thyroid function and circulating thyroid antibodies. This suggests that there may be an association between rheumatic heart disease and thyroid dysfunction. The findings emphasize the need to formally exclude hyperthyroidism in patients with atrial fibrillation whatever the apparent cause. They also imply a possible autoimmune factor in the pathogenesis of rheumatic heart disease and suggest that patients with rheumatic heart disease may develop clinical or sub-clinical thyroid disease.