Case Report: Atrial Fibrillation After Intravenous Administration of Iodinated Contrast Medium in a Patient With Hepatocellular Carcinoma.
We describe the case of a 73-year-old woman with liver cirrhosis and hepatocellular carcinoma (HCC) who developed 2 distinct episodes of paroxystic atrial fibrillation (AF) each of which occurred 1 to 4 hours after iodine medium contrast-enhanced computed tomography. Sinus rhythm was restored by amiodarone therapy after the first AF episode and by electrical cardioversion after the second one. A careful clinical, biochemical, and instrumental examination showed that the patient had subclinical hyperthyroidism and moderate mitral insufficiency with mild atrial enlargement.Thus, the coexistence of both subclinical disthyroidism and of cardiac anatomical alterations may have predisposed the patient to AF that in fact occurred when exogenous iodine administration triggered a hyperthyroidism status.
From Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy (SM, RF, CS, GR, GS); Department of Internal Medicine, University Hospital of Messina, Messina, Italy (GR); and Department of Human Pathology, University Hospital of Messina, Messina, Italy (GS).
Sergio
S
Maimone
Roberto
R
Filomia
Carlo
C
Saitta
Giovanni
G
Raimondo
Giovanni
G
Squadrito
D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D001549:Benzamides / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000009:adverse effects*; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis / Q000503:physiopathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology; D011759:Pyrrolidines / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D001549:Benzamides; D003287:Contrast Media; D011759:Pyrrolidines; C056836:iodopride; D000638:Amiodarone