To assess whether the number of patients with a cardiac chief complaint and their characteristics differed between before and after two major earthquakes that struck Croatia in 2020.
We collected ...data on all visits of patients with a cardiac chief complaint examined in the emergency departments of six hospitals nearest to the epicenters. Patients seen during the 7 days before the earthquake were compared with those seen on the day and during the 6 days after the earthquake.
Patients seen after the earthquake were younger (68 59-79 vs 72.5 65-80; P<0.001) and less frequently had cardiovascular disease (32.9% vs 42.8%; P<0.001). This group less frequently had the primary diagnosis of acute myocardial infarction (AMI) (15.6% vs 21.9%; P=0.005), heart failure (9.3% vs 19.4%; P<0.001), dysregulated hypertension (13.9% vs 19.4%; P=0.01), but more frequently had non-anginal chest discomfort (28.8% vs 18.0%; P<0.001). In a subgroup analysis of patients seen in hospitals located within 20 km from the epicenter, significantly more patients seen after the earthquake compared with those seen before the earthquake presented with AMI (14.5% vs 22.8%; P=0.028), acute elevation of blood pressure (10% vs 21.8%, P=0.001), and paroxysmal arrhythmias treated with electrocardioversion (0.9% vs 4.5%, P=0.022).
After two moderately strong earthquakes, hospitals within 20 km from the epicenter saw a significant increase in acute cardiac conditions such as elevated blood pressure, AMI, and cardioverted arrhythmias. Eventually, these earthquakes had no impact on the outcomes of the studied population.
Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous ...coronary intervention (PCI) in acute myocardial infarction without ST-elevation. The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient via iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI.
Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous ...coronary intervention (PCI) in acute myocardial infarction without ST-elevation.The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient via iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI. Key words: Acute thyroiditis; Thyrotoxicosis; Percutaneous coronary intervention; Acute coronary syndrome; Iodinated contrast agent Destruktivni tireoiditis samoogranicavajuca je bolest obiljezena akutnim otpustanjem tireoidnih hormona. Prikazujemo bolesnika s akutnim bolnim tireoiditisom nastalim uslijed perkutane koronarne intervencije (PCI) u akutnom koronarnom sindromu bez ST elevacije. Nagla pojava boli u predjelu stitnjace, povecanje vrijednosti fT3 i fT4 te parametara upale bili su konkluzivni s dijagnozom akutnog destruktivnog tireoiditisa. Navedena bolest vjerojatno proizlazi iz lokalne upale izazvane velikom kolicinom joda apliciranog kao jodni kontrast tijekom PCI. Zbog sve veceg broja bolesnika podvrgnutih koronarnoj angiografiji invazivni kardiolozi trebali bi biti svjesni potencijalne opasne disfunkcije stitne zlijezde nastale upotrebom jodnog kontrasta. Cilj naseg rada je, kroz konkretan klinicki slucaj, prikazati i raspraviti o patofiziologiji, klinickoj prezentaciji, terapiji i preventivnim mjerama u bolesnika koji razviju poremecaj rada stitnjace nakon PCI. Kljucne rijeci: Akutni tireoiditis; Tireotoksikoza; Perkutana koronarna intervencija; Akutni koronarni sindrom; Jodni kontrast
Destruktivni tireoiditis samoograničavajuća je bolest obilježena akutnim otpuštanjem tireoidnih hormona. Prikazujemo
bolesnika s akutnim bolnim tireoiditisom nastalim uslijed perkutane koronarne ...intervencije (PCI) u akutnom koronarnom
sindromu bez ST elevacije. Nagla pojava boli u predjelu štitnjače, povećanje vrijednosti fT3 i fT4 te parametara upale bili su
konkluzivni s dijagnozom akutnog destruktivnog tireoiditisa. Navedena bolest vjerojatno proizlazi iz lokalne upale izazvane
velikom količinom joda apliciranog kao jodni kontrast tijekom PCI. Zbog sve većeg broja bolesnika podvrgnutih koronarnoj
angiografiji invazivni kardiolozi trebali bi biti svjesni potencijalne opasne disfunkcije štitne žlijezde nastale upotrebom jodnog
kontrasta. Cilj našeg rada je, kroz konkretan klinički slučaj, prikazati i raspraviti o patofiziologiji, kliničkoj prezentaciji,
terapiji i preventivnim mjerama u bolesnika koji razviju poremećaj rada štitnjače nakon PCI.
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