Acute dyspnea following knee joint total endoprosthesis – a diagnostic surprise

Abstract

Acute dyspnea, sometimes dramatic, is most often caused by cardiovascular or respiratory disease. However, although rare, thyroid dysfunction may present a similar clinical picture with equally serious and life-threatening consequences. Therefore, every occurrence of acute dyspnea represents a special medical challenge in diagnosis and treatment. We present a case of 81-year-old male admitted to the rehabilitation department five days after a knee joint total endoprosthesis and developed acute dyspnea two days later. An emergency diagnostic was performed and confirmed an airway stenosis through a previously undiagnosed enlarged thyroid gland. Although in most cases an acute life-threatening postoperative dyspnea indicates a cardiac or pulmonary problem, other diseases must be taken into consideration.

1. Sugiura T, Yamanaka S, Takeuchi H, Morimoto N, Kamioka M, Matsumura Y. Autoimmunity and pulmonary hypertension in patients with Graves’ disease. Heart Vessels. 2015;30(5):642-6.
2. Mathot V, Oosterwerff E, van Pampus MG, Riezebos R. Pulmonary hypertension in a pregnant patient with thyrotoxicosis due to Graves’ disease: considerations with respect to treatment. BMJ Case Rep. 2014, bcr2013201916.
3. Zuhur SS, Baykiz D, Kara SP, Sahin E, Kuzu I, Elbuken G. Relationship among pulmonary hypertension, autoimmunity,
thyroid hormones and dyspnea in patients with hyperthyroidism. Am JMed Sci. 2017;353(4):374-80.
4. Chen DC, Williams DM, Aronowitz PB. Long-standing goiter causing acute airway compromise. J Gen Intern Med. 2016;31(12):1539-40.
5. Kadhim AL, Sheahan P, Timon C. Management of lifethreatening airway obstruction caused by benign thyroid disease. J Laryngol Otol. 2006;120(12):1038-41.
6. Aghajanzadeh M, Asgary MR, Mohammadi F, Darvishi H, Safarpour Y. An investigation into symptoms, diagnosis, treatment, and treatment complications in patients with retrosternal goiter. J Family Med Prim Care. 2018;7(1):224-9.
7. Dias T, Santos A, Mesquita C, Santos RM. Acute airway obstruction due to benign multinodular goitre. BMJ Case Rep. 2019;12(4):e228095.
8. Dell’Aquila M, De Matteis A, Bolino G, Urciuoli P, Fineschi V, Maiese A. Death due to external compression of the trachea in a patient with multinodular hemorrhagic goiter. Forensic SciMed Pathol. 2019;15(3):509-12.
9. Ito T, Shingu K, Maeda C, Kitazawa M, Mizukami Y, Hiraguri M, et al. Acute airway obstruction due to benign asymptomatic nodular goiter in the cervical region: a case report. Oncol Lett. 2015;10(3):1453-5.
10. Bayhan Z, Zeren S,Ucar BI,Ozbay I, Sonmez Y,MestanM, et al. Emergency thyroidectomy: due to acute respiratory failure. Int J Surg Case Rep. 2014;5(12):1251-3.
Files
IssueVol 7 No 4 (2023): Autumn (October) QRcode
SectionCase (report / study)
DOI 10.18502/fem.v7i4.14478
Keywords
Airway Obstruction Diagnosis Dyspnea Goiter
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Miletic B, Röschel A, Jovanovic Z, Courteney U. Acute dyspnea following knee joint total endoprosthesis – a diagnostic surprise. Front Emerg Med. 2023;7(4):e40.

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