Mean LOS: 6.3 days Description: MEDICAL: Endocrine Disorders with CC
I I yperthyroidism is a condition caused by excessive overproduction of thyroid hormone by the thyroid gland. The thyroid hormones (triidothyronine [T3] and thyroxine [T4]), produced in the thyroid gland under the control of thyroid-stimulating hormone (TSH), regulate the body's
470 Hyperthyroidism metabolism. Sustained thyroid hormone overproduction, therefore, causes a hypermetabolic state that affects most of the body organs, such as the heart, gastrointestinal tract, brain, muscles, eyes, and skin.
The seriousness of the disease depends on the degree of hypersecretion of the thyroid hormones. As the levels of thyroid hormones rise, the risk of life-threatening cardiac problems becomes progressively greater. The most common form of hyperthyroidism is called Graves' disease or thyrotoxicosis. Graves' disease is associated with hyperthyroidism, eye disorders, and skin disorders, and when uncontrolled, vital organs are stressed to their capacity. It is also associated with many autoimmune diseases such as diabetes mellitus, Addison's disease, systemic lupus erythematosus, rheumatoid arthritis, myasthenia gravis, and pernicious anemia.
Cardiac stress from increased myocardial oxygen requirements can lead to serious cardiovascular complications, such as systolic hypertension, myocardial infarction, or heart failure. Large goiters can cause pressure on the neck and trachea, which can result in respiratory distress. Opthalmopathy can result in corneal ulceration and loss of vision. Metabolic hyperactivity can cause high levels of anxiety, insomnia, and psychoses. The most severe form of hyperthyroidism is thyrotoxic crisis, known also as thyroid storm or thyrotoxicosis. This condition, which occurs when the body can no longer tolerate the hypermetabolic state, is a nursing and medical emergency and is fatal if not treated. Thyroid storm may be participated by a physiological stressor such as diabetic ketoacidosis, infection, trauma, or surgery.
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