Journal List > Kosin Med J > v.28(2) > 1057002

Lee, Choi, Lee, Yoo, Choi, and Park: A Case of Pulmonary Hypertension Recurred by Graves’ Disease

Abstract

A few cases of severe pulmonary hypertension with right heart failure associated with Graves’ disease were reported in the literature. However, cases of pulmonary hypertension with right heart failure recurred by Graves’ disease is very rare. We describe the case of a 60-year old woman who had been treated pulmonary hypertension caused by right pulmonary artery thromboembolism seven years ago. Recently, her pulmonary hypertension with right heart failure was recurred by Graves’ disease. The patient’s symptoms of pulmonary hypertension was resolved after treatment of Graves’ disease.

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Fig. 1.
(A) Huge sized thrombus in right pulmonary artery was showed in chest CT of 7 years before admission, (B) On admission day, chest CT revealed no evidence of pulmonary arterial thrombus.
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Fig. 2.
On admission day, the electrocardiography showed normal sinus rhythm, right ventricular hypertrophy and ST depression in pre-cordial leads.
kmj-28-171f2.tif
Fig. 3.
On admission day, transthoracic-echocardiography revealed severe pulmonary hypertension. (A) Pressure gradient between right atrium and ventricle is 85.7 mmHg, (B) Right ventricle is markedly enlarged. Left ventricle showed D-shape appearance.
kmj-28-171f3.tif
Fig. 4.
Ultrasonography of the thyroid. (A) Sonogram showed diffuse enlarged thyroid gland with heterogenous echogenecity (0.92 cm of isthmus, 2.7 cm of right lobe, 2.36 cm of left lobe), (B) Sonogram presented thyroid gland with hypervascularity.
kmj-28-171f4.tif
Fig. 5.
Non-visualization of both thyroid lobes (I-131 uptake = 1%).
kmj-28-171f5.tif
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