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Circulatory function in thyrotoxicosis and simple goiter


, : Circulatory function in thyrotoxicosis and simple goiter. Jour Osaka City Med Center 7(11): 1205-1229

A report is made of estimations of blood pressure, pulse rates and ecg on 39 patients with thyrotoxicosis and 31 patients with simple goiter, before and after Master's standard two-step test. Similar studies are repeated after the medication of mercaptoimidazole, radioactive iodine (I131) and desiccated thyroid. Labile high systolic and low diastolic blood pressure and definite tachycardia are found in many patients with thyrotoxicosis. After the exercise test, the time required for the pulse rate to regain a control level is prolonged in thyrotoxicosis, and this time proves to be a valuable index for evaluating cardiovascular conditions. Tachycardia or a slow recovery of pulse rates is also found in a few patients with simple goiter. Electrocardiographically, large Bazett's QT index which shows a normal value after exercise and is found in a quarter of the patients, a high incidence of negative, biphasic or notched T waves in right chest leads and the positive exercise test which is evidenced in about half the patients are emphasized in thyrotoxicosis. Another emphasis is given to high P, R and T waves with occasional flat T and rather frequently encountered ST depression (in 1/4 of the patients) and several kinds of arrhythmia. In simple goiter, almost all values are normal, though a few patients show flat T waves or positive two-step test. One month after the I131 treatment, those cases which show the positive exercise test increase in number and their cardiovascular reserve power decreases temporarily, but they show a gradual improvement. Mercaptoimidazole corrects tachycardia and heightens P and T waves. It lowers R waves and does not affect the exercise test. After the desiccated thyroid treatment in simple goiter, no large influences are observed of the cardiovascular system.

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