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Related Experiment Videos

Cardiac wall motion abnormalities observed in a patient with transient hyperthyroidism.

Takatoshi Sakaki1, Yoshio Fujioka, Takafumi Akagami

  • 1Department of Internal Medicine, Division of Coronary Heart Disease, Hyogo College of Medicine, Japan.

Japanese Heart Journal
|January 19, 2005
PubMed
Summary

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Transient hyperthyroidism may trigger heart conditions like tako-tsubo syndrome or myocardial infarction. This study highlights the link between mild thyroid dysfunction and cardiac events in older adults.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • A 74-year-old female with hypertension and hyperlipidemia presented with cardiac symptoms.
  • Electrocardiography revealed sinus tachycardia and ST-segment elevations, suggestive of acute cardiac injury.

Observation:

  • Echocardiography showed left ventricular apical hypokinesis.
  • Coronary angiography was normal, ruling out obstructive coronary artery disease.
  • Blood tests indicated elevated cardiac enzymes (creatine kinase MB, troponin T) and transient hyperthyroidism markers (free triiodothyronine, free thyroxine, thyroid antibodies).
  • Myocardial scintigraphy demonstrated impaired apical perfusion and fatty acid metabolism.

Findings:

  • The patient's presentation mimicked myocardial infarction but was associated with subclinical hyperthyroidism.

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  • Normal coronary angiography in the presence of elevated cardiac markers and regional wall motion abnormalities points towards non-ischemic cardiomyopathy.
  • The constellation of findings suggests a potential link between transient hyperthyroidism and cardiac dysfunction.

    • Implications:

    • Mild, transient hyperthyroidism may act as a trigger for tako-tsubo cardiomyopathy or myocardial infarction.
    • This case underscores the importance of evaluating thyroid function in patients presenting with acute cardiac syndromes, especially when coronary angiography is normal.
    • Further research is warranted to elucidate the mechanisms linking thyroid dysfunction and cardiac events.