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Related Experiment Videos

Hyperthyroidism complicated with sick sinus syndrome

M Namura1, H Kanaya, M Ikeda

  • 1Department of Cardiology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.

Japanese Circulation Journal
|December 1, 1995
PubMed
Summary

Hyperthyroidism can cause sick sinus syndrome, leading to serious heart rhythm issues. Treating the thyroid condition resolved the patient's arrhythmias and symptoms, negating the need for a pacemaker.

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Area of Science:

  • Cardiology
  • Endocrinology

Background:

  • Sick sinus syndrome (SSS) is a complex cardiac arrhythmia often requiring pacemaker implantation.
  • The relationship between hyperthyroidism and cardiac arrhythmias, particularly SSS, is not fully elucidated.

Observation:

  • A 50-year-old woman presented with syncope, bradycardia, and gastrointestinal symptoms.
  • Initial electrocardiogram revealed sinus arrest; atrial pacing provided temporary relief.
  • Subsequent investigations identified hyperthyroidism, characterized by tremor, exophthalmos, goiter, and elevated thyroid hormones.

Findings:

  • Electrophysiological study demonstrated prolonged corrected sinus recovery time (CSRT), indicative of SSS.
  • Cardiac catheterization ruled out organic coronary or valvular disease.
  • Endomyocardial biopsy showed myocardial hypertrophy but no myocarditis.

Related Experiment Videos

  • Treatment with methylmercaptoimidazole normalized thyroid hormone levels and significantly shortened electrophysiological parameters (AH-time, HV-time, CSRT).

    • Implications:

    • This case highlights hyperthyroidism as a reversible cause of sick sinus syndrome.
    • Effective management of hyperthyroidism can resolve SSS and associated arrhythmias, potentially avoiding permanent pacemaker implantation.
    • Emphasizes the importance of considering endocrine disorders in the differential diagnosis of unexplained bradyarrhythmias.