Although cardiovascular manifestations in thyroid disorders are frequently encountered in clinical practice, atrioventricular (AV) conduction disorders, especially in hyperthyroidism, are rare. There are some proposed mechanisms for AV blocks in hyperthyroidism but the exact mechanism is still unknown. The authors report 2 cases with thyroid function disorders and complete AV block, and the electrophysiologic characteristics of these 2 patients, and they review and speculate on similar reported cases.
Rosenblum R, Delman AJ: First degree heart block associated with thyrotoxicosis. Arch Intern Med112:488-490, 1963.
3.
Davis AC, Smith HL: Complete heart block in hyperthyroidism following acute infections: A report of 6 cases with necropsy findings in 1 case. Am Heart J9:81-89, 1933.
4.
Muggia AL, Stejernholm M, Houle T: Complete heart block with thyrotoxic myocarditis. N Engl J Med283:1099-1100, 1970.
5.
Campus S, Rappelli A, Malavasi A, et al: Heart block and hyperthyroidism. Arch Intern Med135:1091-1095, 1975.
ACC/AHA guidelines for the clinical application of echocardiography. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee on clinical application of echocardiography) developed in collaboration with The American Society of Echocardiography. Circulation95:1686-1674, 1997.
8.
Klein I, Levey GS: New perspectives on thyroid hormones, catecholamines and the heart. Am J Med76:167-172, 1984.
9.
Klein I: Thyroid hormone and the cardiovascular system. Am J Med88:631-637, 1990.
10.
Polikar R, Kennedy B, Ziegler M, et al: Plasma norepinephrine kinetics, dopamine b-hydroxylase, and chromogranine-A in hypothyroid patients before and following replacement therapy. J Clin Endocrinol Metab70:277-281, 1990.
11.
Ralf P, Albert GB, Urs S, et al: The thyroid and the heart. Circulation85:1435-1441, 1993.
12.
Valente M, De Santo C, de MartinoRosaroll P, et al: The direct effect of the thyroid hormone on cardiac chronotropism. Arch Int Physiol Biochim97:431-440, 1988.
13.
Freedberg AS, Papp JG, Vaughan Williams EM: The effect of altered thyroid state on atrial intracellular potentials. J Physiol207:357-369, 1970.
14.
Ansdorf MF, Childers RF: Atrial electrophysiology in experimental hyperthyroidism in rabbits. Circ Res26:575-581, 1970.
15.
Kim D, Smith TW: Effect of thyroid hormone on sodium pump sites, sodium content and contractile response to cardiac glycosides in cultured chick ventricular cells. J Clin Invest74:1481-1488, 1984.
16.
Haber RS, Loeb JN: Stimulation of potassium efflux in rat liver by a low-dose thyroid hormone; evidence for enhanced cation permeability in the absence of Na, K-ATPase induction. Endocrinology118:207-211, 1986.
17.
Olshausen KV, Bischoff S, Kahaly G, et al: Cardiac arrhythmias and heart rate in hyperthyroidism. Am J Cardiol63:930-933, 1989.
18.
Golf S, Lovstadt R, Hansson V: b-adrenoceptor density and relative number of b-adrenoceptor subtypes in biopsies from human right atrial, left ventricular, and right ventricular myocardium. Cardiovasc Res19:636-641, 1985.
19.
Kramer MR, Shilo S, Hershko C: Atrioventricular and sinoatrial block in thyrotoxic crisis. Br Heart J54:600-602, 1985.
20.
Toloune F, Boukili A, Ghafir D, et al: Hyperthyroidism and atrioventricular block. Pathogenic hypothesis. Apropos of case and review of the literature. Arch Mal Coeur Vaiss81:1122, 1131-1135, 1988.
21.
Ho SC, Eng PH, Ding ZP, et al: Thyroid storm presenting as jaundice and complete heart block. Ann Acad Med Singapore27:748-751, 1998.
22.
Miller RH, Corcoran FH, Baker WP: Second- and third-degree atrioventricular block with Graves’ disease: A case report and review of the literature. Pacing Clin Electrophysiol3:702-711, 1980.
23.
Singer Y, Shvartzman P: Second-degree atrioventricular block in Graves’ disease. Harefuah136:28-29, 1999.
24.
Almange C, Turnel F, Badoual P, et al: Hyperthyroidism and atrioventricular heart block. Semin Hop54(45-46):1433-1436, 1978.
25.
Eraker SA, Wickamasekaran R, Goldman S: Complete heart block with hyperthyroidism. JAMA239:1644-1646, 1978.
26.
Archambeaud-Mouveroux F, Roussanne A, Jadaud J, et al: Prolonged hyperthyroidism and recurrent atrioventricular block. Rev Med Interne8:213-217, 1987.