Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Life Threatening Complication of Self-Made Remedy for Controlling High Blood Pressure-Coronary Artery Vasospasm Associated with Iatrogenic Thyrotoxicosis

  • Kang, In Sook (Department of Internal Medicine, Green hospital) ;
  • Pyun, Wook Bum (Department of Internal Medicine, School of Medicine, Ewha Womans University)
  • Received : 2015.10.26
  • Accepted : 2016.01.05
  • Published : 2016.11.30
⟨ Previous Next ⟩

Abstract

We report the case of a middle aged woman who was previously diagnosed with hypertension. She had been drinking a kelp concentrate solution daily for her hypertension instead of taking the prescribed medicine due to her personal beliefs about the kelp solution. As a consequence, she experienced vasospastic angina complicated by myocardial infarction and cardiogenic syncope resulting from iatrogenic thyrotoxicosis. Complementary medicine is widely used by the general population. However, there is still a lack of evidence regarding their efficacy and safety. This case shows that inadequate use of complementary medicine could have no effect and may even be harmful. In patients with chronic diseases such as hypertension, self-care in the form of life style modification, home blood pressure monitoring and medial adherence are important for disease management.

Keywords

References

  1. Chao MT, Wade C, Kronenberg F, Kalmuss D, Cushman LF. Women's reasons for complementary and alternative medicine use: racial/ethnic differences. J Altern Complement Med 2006;12:719-22. https://doi.org/10.1089/acm.2006.12.719
  2. Gohar F, Greenfield SM, Beevers DG, Lip GY, Jolly K. Self-care and adherence to medication: a survey in the hypertension outpatient clinic. BMC Complement Altern Med 2008;8:4. https://doi.org/10.1186/1472-6882-8-4
  3. De Geest S, Sabate E. Adherence to long-term therapies: evidence for action. Eur J Cardiovasc Nurs 2003;2:323. https://doi.org/10.1016/S1474-5151(03)00091-4
  4. Ernst E. Complementary/alternative medicine for hypertension: a mini-review. Wien Med Wochenschr 2005;155:386-91. https://doi.org/10.1007/s10354-005-0205-1
  5. Leung AM, Braverman LE. Consequences of excess iodine. Nat Rev Endocrinol 2014;10:136-42. https://doi.org/10.1038/nrendo.2013.251
  6. Eliason BC. Transient hyperthyroidism in a patient taking dietary supplements containing kelp. J Am Board Fam Pract 1998;11:478-80. https://doi.org/10.3122/jabfm.11.6.478
  7. Mussig K, Thamer C, Bares R, Lipp HP, Haring HU, Gallwitz B. Iodineinduced thyrotoxicosis after ingestion of kelp-containing tea. J Gen Intern Med 2006;21:C11-4.
  8. Zava TT, Zava DT. Assessment of Japanese iodine intake based on seaweed consumption in Japan: A literature-based analysis. Thyroid Res 2011;4:14. https://doi.org/10.1186/1756-6614-4-14
  9. Featherstone HJ, Stewart DK. Angina in thyrotoxicosis. Thyroidrelated coronary artery spasm. Arch Intern Med 1983;143:554-5. https://doi.org/10.1001/archinte.1983.00350030168028
  10. Al Jaber J, Haque S, Noor H, Ibrahim B, Al Suwaidi J. Thyrotoxicosis and coronary artery spasm: case report and review of the literature. Angiology 2010;61:807-12. https://doi.org/10.1177/0003319710365146
  11. Wei JY, Genecin A, Greene HL, Achuff SC. Coronary spasm with ventricular fibrillation during thyrotoxicosis: response to attaining euthyroid state. Am J Cardiol 1979;43:335-9. https://doi.org/10.1016/S0002-9149(79)80023-5
  12. Choi YH, Chung JH, Bae SW, et al. Severe coronary artery spasm can be associated with hyperthyroidism. Coron Artery Dis 2005;16:135-9. https://doi.org/10.1097/00019501-200505000-00001
  13. Bergeron GA, Goldsmith R, Schiller NB. Myocardial infarction, severe reversible ischemia, and shock following excess thyroid administration in a woman with normal coronary arteries. Arch Intern Med 1988;148:1450-3. https://doi.org/10.1001/archinte.1988.00380060214038
  14. Fazio S, Palmieri EA, Lombardi G, Biondi B. Effects of thyroid hormone on the cardiovascular system. Recent Prog Horm Res 2004;59:31-50. https://doi.org/10.1210/rp.59.1.31
  15. Napoli R, Guardasole V, Angelini V, et al. Acute effects of triiodothyronine on endothelial function in human subjects. J Clin Endocrinol Metab 2007;92:250-4. https://doi.org/10.1210/jc.2006-1552
  16. Fukuyama K, Ichiki T, Takeda K, et al. Downregulation of vascular angiotensin II type 1 receptor by thyroid hormone. Hypertension 2003;41:598-603. https://doi.org/10.1161/01.HYP.0000056524.35294.80
  17. Napoli R, Biondi B, Guardasole V, et al. Impact of hyperthyroidism and its correction on vascular reactivity in humans. Circulation 2001;104:3076-80. https://doi.org/10.1161/hc5001.100621
  18. Hermenegildo C, Medina P, Peiro M, et al. Plasma concentration of asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase, is elevated in hyperthyroid patients. J Clin Endocrinol Metab 2002;87:5636-40. https://doi.org/10.1210/jc.2002-020905
  19. Finset A, Gerin W. How can we promote medication adherence and lifestyle changes in hypertensive patients? Patient Educ Couns 2008;72:1-2. https://doi.org/10.1016/j.pec.2008.05.008
  20. Bell RA, Kravitz RL. Physician counseling for hypertension: What do doctors really do? Patient Educ Couns 2008;72:115-21. https://doi.org/10.1016/j.pec.2008.01.021