Occult Thyrotoxicosis in Patients with Atrial Fibrillation and an Acute Arterial Embolism

M. Monreal, E. Lafoz, M. Foz, A. Sanmarti, I. Salinas, L. Audi, E. Viver

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15 Citations (Scopus)


Serum total thyroxine, triiodothyronine, and thyrotropin response to thyro tropin-releasing hormone (TRH-TSH test) were measured in 126 consecutive patients admitted with atrial fibrillation: 33 patients with an acute arterial limb embolism (Group I), 31 patients with an acute embolic stroke (Group II), and 62 patients without any arterial occlusion (Group III). A blunted TRH-TSH test, suggestive of thyrotoxicosis, was found in 5 patients in Group I, 8 patients in Group II, and 2 patients in Group III. The diagnosis of hyperthyroidism was confirmed in 8 patients (by repeated TRH-TSH test and scintigraphy): 4 pa tients in Group I (12.1%) and 4 patients in Group II (12.9%). All of them had a nonvalvular atrial fibrillation. Thyrotoxicosis should not be recognized in 6 of them if TRH-TSH test was not performed, because peripheral hormone levels were normal. Five of these 8 patients with thyrotoxicosis had reversion to sinus rhythm after treatment with carbimazole, either spontaneously or after car dioversion. This outcome prevented prolongation of anticoagulant therapy for an indefinite time. © 1988, Sage Publications. All rights reserved.
Original languageEnglish
Pages (from-to)981-985
Issue number11
Publication statusPublished - 1 Jan 1988


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