Recurrent vasodilator-refractory acute coronary syndrome as the exclusive manifestation of Graves disease

Perioperative Thyroid Function in a Patient With Angina Pectoris Coexisting With Graves’ Disease Undergoing Coronary Artery Bypass Grafting

“…HYPERTHYROIDISM CAUSES hemodynamic changes, including tachyarrhythmia, increased preload, and decreased afterload, resulting in cardiovascular events such as myocardial ischemia that adversely affect mortality. [1][2][3][4] The effect of perioperative thyroid hormone level changes, including those during cardiopulmonary bypass (CPB), in the Graves' disease patient undergoing cardiac surgery are unknown, whereas thyroid storm after surgery is possibly fatal. 5 Therefore, cardiac surgery in the patient with uncontrolled hyperthyroidism presents a significant challenge to anesthesiologists.…”

“…Cardiac events in patients with hyperthyroidism closely relate to mortality of the disease. [1][2][3][4] Indeed, Graves' disease is known as an inducer of vasospastic angina pectoris. 4 However, arteriosclerotic diseases are less likely in Graves' disease because the incidence of the disease peaks between 30 and 50 years of age.…”

“…[1][2][3][4] Indeed, Graves' disease is known as an inducer of vasospastic angina pectoris. 4 However, arteriosclerotic diseases are less likely in Graves' disease because the incidence of the disease peaks between 30 and 50 years of age. 2 These results may explain why perioperative changes of thyroid hormone levels in the patient with Graves' disease undergoing cardiac surgery have been unknown.…”