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Related Experiment Videos

Chest pain, enzymes and hypothyroidism.

S R Strachan1, O Afolabi, N Brown

  • 1Cardiology Department, Queen's Medical Centre, University Hospital, Clifton Boulevard, Nottingham, NG7 2UH, UK.

Postgraduate Medical Journal
|February 23, 2000
PubMed
Summary

Severe hypothyroidism can mimic a heart attack, presenting with elevated creatine kinase and ECG changes. Prompt thyroxine treatment resolved these cardiac-like symptoms, highlighting a crucial differential diagnosis.

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Area of Science:

  • Endocrinology
  • Cardiology
  • Internal Medicine

Background:

  • Hypothyroidism is a common endocrine disorder with diverse clinical presentations.
  • Classical symptoms are often straightforward, but atypical presentations can occur.
  • Misdiagnosis is possible when symptoms overlap with other conditions.

Observation:

  • A case of severe hypothyroidism presented with symptoms mimicking acute myocardial infarction.
  • The patient exhibited elevated creatine kinase levels and electrocardiographic abnormalities.
  • These findings are typically associated with cardiac events.

Findings:

  • Thyroid hormone replacement therapy with thyroxine led to the resolution of cardiac-like symptoms.
  • The electrocardiographic abnormalities normalized post-treatment.

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  • Creatine kinase levels returned to normal ranges after thyroxine administration.

    • Implications:

    • Severe hypothyroidism should be considered in the differential diagnosis of cardiac events, especially with unexplained creatine kinase elevation and ECG changes.
    • Early recognition and treatment of hypothyroidism can prevent unnecessary cardiac interventions.
    • This case underscores the importance of a comprehensive diagnostic approach in complex clinical scenarios.