What is the pathophysiological mechanism by which thyrotoxicosis causes right heart failure with dilated left atrium?Initial Q: ¿cuál es el mecanismo fisiopatólogico por el cual la tirotoxicosis causa insuficiencia cardiaca derecha con dilatació de aurícula izquierda? Question - in English - has been translated by Google!
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- Answered 12 Nov 2019 Conflict of interest declaration: None A difficult Q to answer, hampered by a lack of access to full-text! In the 2008 paper “Thyrotoxic cardiac disease”  they report: “Heart failure resulting from thyrotoxicosis is due to a tachycardia-mediated mechanism leading to an increased level of cytosolic calcium during diastole with reduced ventricular contractility and diastolic dysfunction, often with tricuspid regurgitation.” I found this recent paper “Thyrotoxic heart failure: A review of clinical status and meta-analysis of electrocardiogram diagnosis and medical clinical management methods”  which, in the abstract, states: “However, the etiology of thyrotoxic HF remains partially understood – is it the consequence of hemodynamic insult, direct toxic effect or both?” I’m slightly loathed to link to the above as (a) I’ve never heard of the journal (2) it’s a single author piece (3) the journal isn’t in PubMed/Medline. In isolation not a big deal for one of those, but all three makes me nervous! I’ve found other articles which appears relevant (to a greater or lesser extent) and links to the full-text are below. I’ll not attempt to summarise them as it’s an area I know little about! Mechanisms in endocrinology: Heart failure and thyroid dysfunction, 2012  Hyperthyroidism and cardiovascular complications: a narrative review on the basis of pathophysiology, 2013  Hyperthyroidism and the Heart  Thyroid Hormones and Cardiovascular Function and Diseases  References 1) https://link.springer.com/article/10.1007/s11897-008-0026-9 2) https://www.oatext.com/thyrotoxic-heart-failure-a-review-of-clinical-status-and-meta-analysis-of-electrocardiogram-diagnosis-and-medical-clinical-management-methods.php#Article 3) https://eje.bioscientifica.com/view/journals/eje/167/5/609.xml 4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832836/ 5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512680/ 6) http://www.onlinejacc.org/content/71/16/1781