title: An unusual cause of cardiothyreosis.
abstract: Severe hyperthyroidism can cause cardiac complications, such as severe rhythm disturbances, heart failure and angina. Gestational trophoblastic disease (GTD) is a rare complication of pregnancy, ranging from benign hydatidiform mole to malignant form. Clinical hyperthyroidism may occur in GTD, as human chorionic gonadotropin (hCG) secreted by molar tissue is structurally similar to thyroid-stimulating hormone. Cardiothyreosis in this context is exceptional. We report the case of a nulligravida 42-year-old woman without thyroid or cardiac history who presented to the emergency department for dyspnoea. Examinations revealed an acute pulmonary oedema and sinus tachycardia. Serum hCG concentration was abnormally high (762 878 UI/l, N < 5). CT scan showed a voluminous uterine mass and eliminated pulmonary embolism. Cardiac output was increased in echocardiography. Complementary blood tests showed a peripheral hyperthyroidism. GTD was evoked in the context of uterine mass and high hCG concentration, which was responsible for inducing clinical hyperthyroidism and cardiothyreosis. A total hysterectomy was performed and histopathological examinations concluded to a non-invasive complete hydatidiform mole (begnin form). hCG fell to normal within 12 weeks, cardiac and thyroid functions normalized after mole evacuation.
authors.affiliation: a Department of Cardiology .
authors.forename: Lucien
authors.initials: L
authors.lastname: Marchand
authors.affiliation: a Department of Cardiology .
authors.forename: Paul
authors.initials: P
authors.lastname: Chabert
authors.affiliation: a Department of Cardiology .
authors.forename: Elise
authors.initials: E
authors.lastname: Chaudesaygues
authors.affiliation: a Department of Cardiology .
authors.forename: Mélanie
authors.initials: M
authors.lastname: Grasse
authors.affiliation: b Department of Obstetrics and Gynecology , St. Joseph and St. Luc Hospital , Lyon , France , and.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bretones
authors.affiliation: c Department of Endocrinology , Nord-Ouest Hospital , Villefranche-Sur-Saône , France.
authors.forename: Julia
authors.initials: J
authors.lastname: Graeppi-Dulac
authors.affiliation: a Department of Cardiology .
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Aupetit
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications* / Q000601:surgery; D006980:Hyperthyroidism / Q000097:blood / Q000150:complications / Q000209:etiology; D007044:Hysterectomy; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000150:complications* / Q000601:surgery
chemical_list: D006063:Chorionic Gonadotropin
keywords: Cardiothyreosis; human chorionic gonadotropin; hydatiform mole; hyperthyroidism; thyroid-stimulating hormone