title: Diagnostic algorithm for atrial fibrillation caused by occult hyperthyroidism.
abstract: Occult hyperthyroidism, a subclinical thyrotoxic state, is not readily identifiable clinically or through routine thyroid function tests. "Idiopathic" atrial fibrillation may be a manifestation of occult hyperthyroidism in the elderly. A normal response on a TRH stimulation test excludes this diagnosis. A blunted TSH response, coupled with elevation of free thyroid hormones and a high radioactive iodine uptake, will settle the diagnosis. Patients with occult hyperthyroidism frequently have toxic adenomas or nonpalpable nodular goiters, and treatment is best achieved with radioactive iodine ablation.
authors.affiliation: Department of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
authors.forename: R A
authors.initials: RA
authors.lastname: Sulimani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology*; D005067:Euthyroid Sick Syndromes / Q000097:blood / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D013960:Thyroid Function Tests; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications / Q000175:diagnosis; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone / Q000097:blood
chemical_list: D013973:Thyrotropin-Releasing Hormone; D013972:Thyrotropin