{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:47Z","timestamp":1784557067300,"version":"3.55.0"},"reference-count":0,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,22]]},"abstract":"\n Summary<\/jats:title>\n Graves\u2019 disease is associated with tachydysrythmia, cardiac ischaemia and cardiomyopathy \u2013 all uncommon in young adults without previous cardiac disease. We present three young individuals who developed cardiac complications after periods of uncontrolled Graves\u2019 disease. Subject 1: A 34-year-old female had severe thyrotoxic symptoms for weeks. Investigations showed fT4: 98.4 (11\u201325 pmol\/L), fT3: 46.9 (3.1\u20136.8 pmol\/L), TSH <0.01 (0.27\u20134.2 mU\/L) and thyrotrophin receptor antibody (TRAb): 34.8 (<0.9 U\/\/l). She had appropriate treatment but several weeks later she became breathless despite improving thyroid function. Echocardiography showed a pericardial effusion of 2.9 cm. She responded well to steroids and NSAIDs but developed active severe Graves\u2019 orbitopathy after early total thyroidectomy. Subject 2: A 28-year-old male developed thyrotoxic symptoms (fT4: 38 pmol\/L, fT3: 13.9 pmol\/L, TSH <0.01 (for over 6 months) and TRAb: 9.3 U\/L). One month after starting carbimazole, he developed acute heart failure (HF) due to severe dilated cardiomyopathy \u2013 EF 10\u201315%. He partially recovered after treatment \u2013 EF 28% and had early radioiodine treatment. Subject 3: A 42-year-old woman who had been thyrotoxic for several months (fT4: 54.3; fT3 >46.1; TSH <0.01; TRAb: 4.5) developed atrial fibrillation (AF) and heart failure. Echocardiography showed cardiomegaly \u2013 EF 29%. She maintains sinus rhythm following early total thyroidectomy (EF 50%). Significant cardiac complications may occur in previously fit young adults, who have had uncontrolled Graves\u2019 disease for weeks to months. Cardiac function recovers in the majority, but early definitive treatment should be discussed to avoid Graves\u2019 disease relapse and further cardiac decompensation.<\/jats:p>\n <\/jats:sec>\n \n Learning points:<\/jats:title>\n \n \n Cardiac complications of Graves\u2019 disease are uncommon in young adults without previous cardiac disease.<\/jats:p>\n <\/jats:list-item>\n \n These complications may however occur if Graves\u2019 disease had been poorly controlled for several weeks or months prior to presentation.<\/jats:p>\n <\/jats:list-item>\n \n Persistent symptoms after adequate control should alert clinicians to the possibility of cardiac disease.<\/jats:p>\n <\/jats:list-item>\n \n Specific treatment of Graves\u2019 disease and appropriate cardiac intervention results in complete recovery in the majority and carries a good prognosis.<\/jats:p>\n <\/jats:list-item>\n \n Early definitive treatment should be offered to them to prevent cardiac decompensation at times of further relapse.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-19-0132","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T11:24:53Z","timestamp":1580124293000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":6,"title":["Significant cardiac disease complicating Graves\u2019 disease in previously healthy young adults"],"prefix":"10.1530","volume":"2020","author":[{"given":"J K","family":"Witczak","sequence":"first","affiliation":[{"name":"1Section of Endocrinology, Department of Medicine, Prince Phillip Hospital"},{"name":"2Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Heath Park, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Ubaysekara","sequence":"additional","affiliation":[{"name":"2Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Heath Park, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Ravindran","sequence":"additional","affiliation":[{"name":"2Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Heath Park, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Rice","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology, Department of Medicine, Prince Phillip Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Yousef","sequence":"additional","affiliation":[{"name":"3Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L D","family":"Premawardhana","sequence":"additional","affiliation":[{"name":"2Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Heath Park, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2020\/1\/EDM19-0132.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2020\/1\/EDM19-0132.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:47:13Z","timestamp":1784555233000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,22]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1530\/edm-19-0132","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,22]]}}}