The Role of Hyperthyroidism in Patients With Myocardial Infarction With Normal Coronary Arteries

Günebakmaz, Özgür; Duran, Mustafa; Uysal, Onur Kadir; Yıldız, Ali

doi:10.1177/0003319712470021

Cited by 3 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hyperthyroidism is prone to acute ischemic heart disease ( 77 , 78 ). The proposed mechanisms responsible for coronary events in hyperthyroidism include a hypercoagulable and hypofibrinolytic state as well as hyperthyroidism-associated coronary vasospasm and increased myocardial oxygen demand ( 79 , 80 ).…”

Section: Discussionmentioning

confidence: 99%

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Wang

Leng

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

The manifestations of hyperthyroidism-related myocardial damage are multitudinous, including arrhythmia, dilated cardiomyopathy, valvular diseases, and even cardiogenic shock. Acute myocarditis induced by thyrotoxicosis had been reported in a few studies. However, attention on its prevalence and underlying mechanisms is sorely lacking. Its long-term harm is often ignored, and it may eventually develop into dilated cardiomyopathy and heart failure. We report a case of Graves' disease with a progressive elevation of hypersensitive cardiac troponin-I at several days after discontinuation of the patient's anti-thyroid drugs. Cardiac magnetic resonance imaging (CMRI) showed inflammatory edema of some cardiomyocytes (stranded enhanced signals under T2 mapping), myocardial necrosis (scattered enhanced signals under T1 late gadolinium enhancement) in the medial and inferior epicardial wall, with a decreased left ventricular systolic function (48%), which implied a possibility of acute myocarditis induced by thyrotoxicosis. The patient was then given a transient glucocorticoid (GC) treatment and achieved a good curative effect. Inspired by this case, we aim to systematically elaborate the pathogenesis, diagnosis, and treatment of hyperthyroidism-induced autoimmune myocarditis. Additionally, we emphasize the importance of CMRI and GC therapy in the diagnosis and treatment of hyperthyroidism-related myocarditis.

show abstract

Section: Discussionmentioning

confidence: 99%

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Wang

Leng

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…Recently, in a pilot study, we 1 compared risk factors in patients with myocardial infarction (MI) with normal coronary arteries (MINCAs) with data from patients with MI with coronary artery stenosis. In a letter to the journal, Gunebakmaz and coworkers 2 comment on the role of hyperthyroidism in patients with MINCA.…”

mentioning

confidence: 99%

“…Since there are a few case reports reporting MI in patients with subclinical hyperthyroidism with angiographically normal coronary arteries, 8–10 Gunebakmaz and coworkers 2 ask for data on thyroid status in our pilot study. 1 The problem is that the incidence of subclinical hyperthyroidism may be as low as approximately 1% in the general population.…”

mentioning

confidence: 99%

Thyroid Dysfunction in Patients With Myocardial Infarction With Normal Coronary Arteries

Agewall

Tornvall

2013

Angiology

View full text Add to dashboard Cite

Recently, in a pilot study, we 1 compared risk factors in patients with myocardial infarction (MI) with normal coronary arteries (MINCAs) with data from patients with MI with coronary artery stenosis. In a letter to the journal, Gunebakmaz and coworkers 2 comment on the role of hyperthyroidism in patients with MINCA.Both hypothyroidism and hyperthyroidism have been associated with increased risk of coronary heart disease (CHD) events in previous reports. Subclinical hyperthyroidism is defined as a patient having normal free thyroxine and total triiodothyronine levels in conjunction with a thyrotropin (TSH) level persistently below the normal range in the absence of factors known to suppress TSH. In the HUNT study, which included 26 707 people without previously known thyroid or cardiovascular disease or diabetes at baseline, a high TSH within the reference range was associated with increased risk of coronary death in women, but not in men after 12 years of follow-up. The risk of coronary death was also increased among women with subclinical hypothyroidism or subclinical hyperthyroidism, compared to women with TSH of 0.50 to 1.4 mU/L. However, thyroid function was not associated with the risk of being hospitalized with MI. 3In a meta-analysis, 55 287 participants with 542 494 personyears from 11 prospective cohorts, the authors reported that subclinical hypothyroidism was associated with an increased risk of CHD events and CHD mortality. 4 Another metaanalysis consisting of 52 674 participants pooled from 10 cohorts reported that endogenous subclinical hyperthyroidism was associated with increased risks of total CHD mortality and incident atrial fibrillation.5 In a population-based cohort study, in patients treated for thyroid dysfunction, event rates among patients with thyroid dysfunction were compared to rates in the general population. There were 15 889 patients with primary hypothyroidism and 3888 patients with hyperthyroidism. There was no increase in all-cause mortality in participants with treated thyroid disease. However, there was increased risk of cardiovascular morbidity in patients with treated primary hypothyroidism and dysrhythmias in treated hyperthyroidism. 6 Also, the risk of heart failure may be increased with both higher and lower TSH levels.7 Individual data on 25 390 participants with 216 248 person-years of follow-up were supplied from 6 prospective cohorts in the United States and Europe. In age-and sex-adjusted analyses, risks of heart failure events were increased with both higher and lower TSH levels.Since there are a few case reports reporting MI in patients with subclinical hyperthyroidism with angiographically normal coronary arteries, [8][9][10] Gunebakmaz and coworkers 2 ask for data on thyroid status in our pilot study.1 The problem is that the incidence of subclinical hyperthyroidism may be as low as approximately 1% in the general population.11 Therefore, our study is far too small to answer this important issue. We need larger studies on patients with MINCA to evaluate this int...

show abstract

Unexpected case of Graves` disease induced myocarditis: a case report

Safitri,

Hasanah,

Atmadikoesoemah

et al. 2024

Cardiovascular Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

Myocarditis due to Graves` disease is rare and has a clinical presentation that mimics acute coronary syndrome. In this case report, a 50-year-old woman was admitted with a clinical presentation of very high-risk non-ST segment elevation myocardial infarction, new-onset atrial fibrillation, and acute heart failure. Normal coronary angiography and the presence of intra-myocardial late gadolinium enhancement based on cardiac MRI led to the diagnosis of myocarditis. The presence of thyroid nodules and elevated thyrotropin receptor antibodies indicated Graves` disease as the underlying cause of myocarditis. Management using Propylthiouracil and the guideline-directed medical therapy for heart failure successfully improved the patient’s condition. Early diagnosis, effective care, and adequate knowledge of the relationship between hyperthyroidism and myocarditis, improve outcomes in Graves’ disease-induced myocarditis.

show abstract

The Role of Hyperthyroidism in Patients With Myocardial Infarction With Normal Coronary Arteries

Cited by 3 publications

References 4 publications

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Thyroid Dysfunction in Patients With Myocardial Infarction With Normal Coronary Arteries

Unexpected case of Graves` disease induced myocarditis: a case report

Contact Info

Product

Resources

About