Improvement in Pulmonary Hypertension and Closure of a Patent Foramen Ovale with Treatment of Hyperthyroidism in a Patient with Graves’ Disease
DOI:
https://doi.org/10.12970/2310-9874.2014.02.03.1Keywords:
Graves’ disease, pulmonary hypertension, patent foramen ovale, closure of patent foramen ovale, treatment for hyperthyroidism.Abstract
Pulmonary hypertension and recurrence of a previously closed patent foramen ovale seen in Graves’ disease patients could be reversed with treatment of hyperthyroidism. We are reporting the case of a 41 year old woman, who presented with features of Graves’ disease and pulmonary hypertension which, in turn, led to a right to left shunt through a patent foramen ovale. After 8 weeks of treatment for hyperthyroidism, her pulmonary artery pressure decreased and patent foramen ovale was not noticeable. This is the first reported case of PFO closure with reduction of pulmonary artery pressure associated with treatment of hyperthyroidism to our knowledge.
References
Montani D, Günther S, Dorfmüller P, Perros F, Girerd B, Garcia G, et al. Pulmonary arterial hypertension. Orphanet J Rare Dis 2013; 8(1): 97. http://dx.doi.org/10.1186/1750-1172-8-97
Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62(25 Suppl): D34-D41. http://dx.doi.org/10.1016/j.jacc.2013.10.029
Chu JW, Kao PN, Faul JL, Doyle RL. High prevalence of autoimmune thyroid disease in pulmonary arterial hypertension. Chest 2002; 122(5): 1668-1673.
Ismail HM. Reversible pulmonary hypertension and isolated right-sided heart failure associated with hyperthyroidism. J Gen Intern Med 2007; 22(1): 148-150. http://dx.doi.org/10.1007/s11606-006-0032-0
Bogaard HJ, Al Husseini A, Farkas L, Farkas D, Gomez-Arroyo J, Abbate A, et al. Severe pulmonary hypertension: The role of metabolic and endocrine disorders. Pulm Circ 2012; 2(2): 148-154. http://dx.doi.org/10.4103/2045-8932.97592
Virani SS, Mendoza CE, Ferreira AC, de Marchena E. Graves’ disease and pulmonary hypertension: report of 2 cases. Tex Heart Inst J 2003; 30(4): 314-315.
Guchlerner M, Kardos P, Liss-Koch E, Franke J, Wunderlich N, Bertog S, et al. PFO and right-to-left shunting in patients with obstructive sleep apnea. J Clin Sleep Med 2012; 8(4): 375-380. http://dx.doi.org/10.5664/jcsm.2026
Sun XG, Hansen JE, Oudiz RJ, Wasserman K. Gas exchange detection of exercise-induced right-to-left shunt in patients with primary pulmonary hypertension. Circulation 2002; 105(1): 54-60.
Soliman A, Shanoudy H, Liu J, Russell DC, Jarmukli NF. Increased prevalence of patent foramen ovale in patients with severe chronic obstructive pulmonary disease. J Am Soc Echocardiogr 1999; 12(2): 99-105.
Hwang JY, Bae SH, Lee JM, Kim DG, Ahn JH, Kim MS, et al. A case of pulmonary arterial hypertension associated with hyperthyroidism, persistent after euthyroidism was obtained. Korean Circ J 2010; 40(11): 593-595. http://dx.doi.org/10.4070/kcj.2010.40.11.593