Severe Hyperthyroidism Presenting with Acute ST Segment Elevation Myocardial Infarction

Abstract

Introduction. Acute myocardial infarction is life-threatening. A cardiac troponin rise accompanied by typical symptoms, ST elevation or depression is diagnostic of acute myocardial infarction. Here, we report an unusual case of a female who was admitted with chest pain. However, she did not present with a typical profile of an acute myocardial infarction patient. Case Presentation. A 66-year-old Han nationality female presented with chest pain. The electrocardiogram (ECG) revealed arched ST segment elevations and troponin was elevated. However, the coronary angiography showed a normal coronary arterial system. Thyroid function tests showed that this patient had severe hyperthyroidism. Conclusion. Our case highlights the possibility that hyperthyroidism may cause a large area of myocardium injury and ECG ST segment elevation. We suggest routine thyroid function testing in patients with chest pain.

"Type 2 Acute Anterior St-Elevation Myocardial Infarction Secondary to Hyperthyroidism: A Case Report"

“…The relation between hyperthyroidism and heart disease was first described in the middle of the last century. Data indicate that high levels of free triiodothyronine lead to the occurrence of coronary events 2.6 times more often compared to normal 4 . The underlying atherosclerotic coronary artery disease, embolization, direct vascular endothelial damage, mismatch between oxygen demand and blood supply, and vasospasm arising from an overactivated sympathetic nervous system are involved 2,5 .…”

Cardiorespiratory Failure in Thyroid Storm: Case Report and Literature Review

“…It is worth noting that, as in our case a small increase in troponin in thyroid storm may not necessarily be due to atherosclerotic coronary artery disease, but a result of tachycardia [ 36 ], coronary artery spasm [ 37 ], Takotsubo cardiomyopathy [ 38 , 39 ].…”

Dolor torácico y elevación del segmento ST en paciente de 21 años con hipertiroidismo en debut: Reporte de caso

“…Si bien los hallazgos presentados en este caso sugieren una elevación del segmento ST por vasoespasmo coronario secundario a tirotoxicosis, es importante tener en cuenta diagnósticos diferenciales como el síndrome de Takotsubo, un síndrome cardiaco de presentación aguda, que se caracteriza por hallazgos anormales de la contractilidad de la pared miocárdica, que llevan, generalmente, a insuficiencia cardiaca aguda, sin enfermedad de las arterias coronarias epicárdicas. Su presentación clínica tiene una amplia gama de patrones clínicos diferentes, y se desencadena de forma frecuente tras estrés emocional o enfermedades graves que se acompañen de activación del sistema nervioso simpático (16).…”