Joseph M. Tibaldi, MD; Daniel L. Lorber, MD
To the Editors: The preventive care guidelines (1) reached our desks the same week that the President of the United States was hospitalized for atrial fibrillation. The guidelines contain a recommendation against routine screening for thyroid disease in persons over 65 years of age. In such patients, however, hyperthyroidism may not present in the classical manner.
The President's atrial fibrillation was found to be secondary to Graves disease in the absence of a palpable goiter. Although President Bush had had a "complete" physical examination only 6 weeks before this episode, thyroid function had not been tested. His doctor felt
Tibaldi JM, Lorber DL. Preventive Care Guidelines. Ann Intern Med. ;115:406–407. doi: 10.7326/0003-4819-115-5-406
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Published: Ann Intern Med. 1991;115(5):406-407.
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