L-thyroxine in the treatment of solitary nodular non-toxic goiter in concomitant coronary heart disease

Endocrinological and cardiological parameters were assessed in coronary patients with nodular euthyroid goiter before and during treatment in order to define the optimal protocols of L-thyroxin therapy. Ultrasonic examination of the thyroid, fine needle puncture biopsy and cytological analysis of biopsy specimens, measurements of thyrotropic hormone, electrocardiography, and high resolution electrocardiography were carried out. The results helped distinguish the cardiological criteria for decreasing the dose of L-thyroxin or its discontinuation in coronary patients with nodular goiter and define the indications for such therapy in this patient population. Therapy with L-thyroxin is justified in the above patient population only on condition of monitoring the cardiovascular status. Therefore, the presence of coronary disease or its risk factors in a patient with nodular colloid proliferating goiter is not a contraindication preventing thyroxin therapy in adequate doses.