SDÜ Tıp Fakültesi Dergisi, Cilt 9, Sayı 4 (2002)

Refractory alkalosis developed after cardiac arrest: Apathetic thyrotoxicosis

Füsun Eroğlu, Lütfi Yavuz, Erol Eroğlu, Berit G. Ceylan

Özet


SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2002 Aralık; 9(4)



Refractory alkalosis developed after cardiac arrest: Apathetic thyrotoxicosis


Pusun Eroglu, Lutfi Yavuz, Erol Eroglu, Berit G Ceylan


Özet

Kardiyak arrest sonrası tedaviye dirençli alkalozis gelişmesi: Apatetik tirotoksikoz

Hipertiroidi varolan kalp hastalığını arttırabilir, atrial fibrilasyon ve kronik kalp yetmezliğine neden olabilir. Kardiak arrest sonrasında tedaviye dirençli alkaloz gelişimesinin nedeni bu olgumuzda olduğu gibi 'apatetik tirotoksikoz' olabilir. Bu nedenle atrial fibrilasyonlu yaşlı olgularda subklinik hipertiroidizm olasılığı akılda tutulmalı ve araştırılmalıdır. Hipertiroidik yaşlı hastalarda plazma tiroid hormonlarındaki artış genellikle orta düzeydedir ve hipertiroidiye bağlı gerçek klinik durum atrial fibrilasyon ve kalp yetmezliğinin semptomları nedeniyle maskelenmiş olabilir



Anahtar kelimeler: solunumsal alkaloz, kardiyak arrest, apatetik tirotoksikoz.



Abstract

The increase of plasma thyroid hormones in elderly patients is generally with a mild elevation and the real clinical scheme due to hyperthyroid is hidden because of the symptoms of heart f ailure and atrial f ibrillation. A woman patient at 71 years old made an application to the emergency service with the complaints of abdom-inal distention and a period of tvventy days without defecation. An atrial fibrillation with high ventricular pulse was found in the first examination. After the resolution of ileus the patient had a cardiac arrest. it was observed that alkalosis which was resistance to therapy developed after cardiac arrest. We investigated the reasons of the alkalosis which was resistant to therapy. The results of the thyroid functions tests showed that the patient had an undiagnosed hyperthyroidism before.

Thyrotoxicosis can increase the existing heart disease, atrial fibrillation and chronic heart failure. Alkalosis which is resistance to therapy develops after cardiac arrest, the reason might be the apathetic thyrotoxicosis. Thus, the elderly patients with atrial fibrillation, subclinical hyperthyroidism should be investigated.



Keywords: Respiratory alkalosis, cardiac arrest, apathetic thyrotoxicosis.

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