[HSF] hypothyroidism

[Douville, Chuck]

Thanks to all.. Our endocrinologist advised that if the T4 level was normal, which it was, that we proceed, even though the TSH level was still 10. She said the pt had sufficient thyroid hormone for normal cardiac function. I did the pt's operation today; uneventful CABG. He is extubated and doing fine.

________________________________

From: openheart-l-bounces at lists.hsforum.com on behalf of Mark Levinson
Sent: Wed 9/5/2007 8:25 PM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] hypothyroidism




On Sep 3, 2007, at 9:55 PM, Douville, Chuck wrote:

> I was asked to see a pt today who has amiodarone induced 
> hypothyroidsm. His TSH was 70  and is now down to 20. What TSH 
> level would you all insist on before offering this pt CABG with EF 
> 25% and left main and class $ angina.? My preferecence is to wait, 
> of course until it is normal, but that may not be possible. Any 
> suggestions? thanks chuckdouville

I don't know how long you can wait, but I would try to wait until the 
TSH in normal or nearly normal.   On my last such case, I operated 
when the TSH was just barely above the normal range and she was 
fine.    But I don't like to operate on a patient that is still 
hypothyroid...

IV T3 is available for resuscitating these hearts, but is very 
expensive and not stocked in most institutions.

Mark

Mark M. Levinson, MD
Founder, Editor-in-Chief,
The Heart Surgery Forum
WWW: <http://www.hsforum.com>
Email: <mmLevinson at hsforum.com>



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