Graves disease induced rapid ventricular response atrial fibrillation in association with hemorrhagic transformation in patient with ischemic stroke

Sagung I. Saraswati; Dewi C. Wulandari; Dessie Yuliani

doi:10.18203/2349-3933.ijam20243786

Authors

Sagung I. Saraswati Department of Internal Medicine, Wangaya Regional Hospital, Denpasar, Bali, Indonesia
Dewi C. Wulandari Department of Internal Medicine, Wangaya Regional Hospital, Denpasar, Bali, Indonesia
Dessie Yuliani Department of Neurology, Wangaya Regional Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20243786

Keywords:

Grave’s disease, Hemorrhagic transformation, Ischemic stroke

Abstract

Graves’ disease is the most common etiology of hyperthyroidism caused by the presence of autoantibodies that stimulate the thyroid-stimulating hormone receptor (TSH-R). If graves' disease is not effectively treated, it can result in several complications, including atrial fibrillation, which affects 5-15% of patients with the condition. In this case, we report a 48-years-old male with hemorrhagic transformation in patient with ischemic stroke associated with Graves' disease, which occurred as a result of complications from atrial fibrillation. The patient has a history of ischemic stroke about one month ago and presented to the emergency department with a relapse of symptoms that had previously improved. Based on the history, physical examination, and supporting tests, a triad of graves' disease was identified, which supported the patient's diagnosis, including thyrotoxicosis, diffuse goiter, and ophthalmopathy. This case report discusses the mechanisms and factors that contribute to hemorrhagic transformation with a history of previous ischemic stroke in a patient with graves' disease, as well as comprehensive treatment approaches.

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