title: Unusual presentation of thyrotoxicosis as complete heart block and renal failure: a case report.
abstract: BACKGROUND
  Thyrotoxicosis is a clinical entity often very difficult to diagnose without biochemical confirmation as its clinical features can be highly varied. The most common cardiac manifestations of thyrotoxicosis are resting sinus tachycardia, supraventricular tachycardia including atrial fibrillation and atrial flutter with or without cardiac failure. Bradycardia and atrio-ventricular conduction defects are very uncommon in thyrotoxicosis.
  
  
  METHODS
  We report the case of a 59-year-old Caucasian man presenting with progressive weight loss, abnormal liver function, acute renal failure and complete heart block due to thyrotoxicosis.
  
  
  CONCLUSIONS
  Thyrotoxicosis should be considered as a possible diagnosis in patients with bradycardia and heart blocks associated with abnormal symptoms like weight loss. Nevertheless, the clinical, electrophysiological and biochemical abnormalities associated with thyrotoxicosis may be completely reversible restoring euthyroid state.
authors.affiliation: City Hospital, Sandwell and West Birmingham Hospitals, NHS Trust, Birmingham, B18 7QH, UK.
authors.forename: Suresh
authors.initials: S
authors.lastname: Krishnamoorthy
authors.forename: Rajay
authors.initials: R
authors.lastname: Narain
authors.forename: John
authors.initials: J
authors.lastname: Creamer