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Article
May 14, 1932

"MYXEDEMA HEART" WITHOUT EVIDENCE OF CARDIAC INSUFFICIENCYREPORT OF TWO CASES

Author Affiliations

BOSTON; SAN FRANCISCO; BOSTON

From the Medical and Research departments of the Boston Dispensary and from the Thyroid Clinic of the Beth Israel Hospital.

JAMA. 1932;98(20):1721-1725. doi:10.1001/jama.1932.02730460025010
Abstract

In 1918, Zondek1 reported that a specific cardiac abnormality was sometimes associated with myxedema, and he called it "myxedema heart." He observed four such cases in which the condition was characterized by enlargement of the heart, feeble cardiac action (observed with a fluoroscope), slow heart beat, low amplitude of the auricular (P) and final ventricular (T) waves in the electrocardiogram, and normal blood pressure. Furthermore, after the administration of thyroid the size of the heart diminished, its action became more vigorous, its rate increased, and the P and T waves of the electrocardiogram became more upright, while the blood pressure remained normal. He mentioned nothing about the presence of symptoms of cardiac insufficiency. Before Zondek, Eppinger,2 in 1917, writing on the subject of edema, had described two cases of enlargement of the heart and cardiac insufficiency with marked edema, in which previous therapy with digitalis and diuretics had

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