Reversible, severe mitral regurgitation in thyrotoxic Graves' disease

BMJ Case Rep. 2021 Feb 4;14(2):e239626. doi: 10.1136/bcr-2020-239626.

Abstract

Mitral valve prolapse is a common finding in Graves' disease. However, severe mitral regurgitation (MR) is a relatively uncommon manifestation of Graves' disease. We report a case of a 32-year-old woman with toxic Graves' disease and MR. The echocardiogram was suggestive of severe MR with biventricular failure, severe enough to be considered for mitral valve replacement. With medical control of the thyrotoxic state, a repeat echocardiogram revealed only trace MR, with normal left ventricular function. The timely management of the thyrotoxic state in this patient with Graves' disease and moderate to severe MR possibly related to myxomatous degeneration, averted the need for mitral valve replacement.

Keywords: hyperthyroidism; thyrotoxicosis; valvar diseases.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Antithyroid Agents / therapeutic use*
  • Echocardiography
  • Fatigue / etiology
  • Female
  • Graves Disease / physiopathology*
  • Humans
  • Hyperthyroidism* / diagnosis
  • Hyperthyroidism* / drug therapy
  • Methimazole / therapeutic use*
  • Mitral Valve Insufficiency
  • Propranolol / therapeutic use*

Substances

  • Adrenergic beta-Antagonists
  • Antithyroid Agents
  • Methimazole
  • Propranolol