CAse Report
Year: 2020 | Month: June | Volume: 10 | Issue: 6 | Pages: 280-285
A Case of Grave’s Disease with Unusual Presentation
Manish Kumar1, Ezema Ndubuisi Kenneth2, Mohammad Najim uddin3, Monika Soni4, A Saifudeen5
1Department of Anaesthesia and critical care , Sultan Qaboos Hospital, Po Box 98 , 211- Salalah, Sultanate of Oman.
2,5Department of Medicine , Sultan Qaboos Hospital, Po Box 98 , 211- Salalah , Sultanate of Oman.
3Department of Neurology , Sultan Qaboos Hospital, Po Box 98 , 211- Salalah , Sultanate of Oman.
4Department of Ophthalmology, Al Zahir Medical Complex,, Po Box 1731 , 211- Salalah, Sultanate of Oman.
Corresponding Author: A Saifudeen
ABSTRACT
Hyperthyroidism is a common metabolic disorder with many cardiovascular manifestations. In rare cases, untreated hyperthyroidism can lead to thyrotoxic cardiomyopathy with severe left ventricular (LV) dysfunction and if its associated with myestheniia gravis it can result into the acute respiratory failure.This case report aims to discuss the pathogenesis of heart failure and respiratory failure in hyperthyroidism and the available treatment options.
A 26 yrs old male patient with a past history of uncontrolled hyperthyroidism has presented with anxiety, difficult breathing and irrelevant talking. After doing examination and full workup he was found to have left ventricular failure and associated acute respiratory failure . Acute respiratory failure was a presentation of masked myasthenia gravis association. Beta-blockers and anti-thyroid medication was started and patient was stabilized.
A good medical history along with clinical examination can reveal the diagnosis and the TSH level should be checked as a part of the initial laboratory workup of every patient with new-onset CHF. One should always keep association of myasthenia gravis in mind.
Key words: Thyrotoxicosis, myasthenia gravis, acute respiratory failure, left ventricular failure.