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Case report: coronary vasospasm--relation to the hyperthyroid state
D Moliterno1, C R DeBold, R M Robertson
1Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232.
Insights
Hyperthyroidism can cause myocardial ischemia through coronary artery spasm. This study clarifies the link between elevated thyroid hormones and vasospasm, highlighting the need to check thyroid status in affected patients.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Angina is common in hyperthyroidism, but coronary artery spasm as a cause is rarely reported.
- Thyroid hormone's impact on cardiac function is significant, yet its role in vasospastic angina requires further elucidation.
Observation:
- A case study demonstrated recurrent myocardial ischemia episodes.
- These episodes correlated with transient increases in thyroid hormone levels.
Findings:
- The study clarifies the relationship between hyperthyroidism and coronary artery spasm.
- Repetitive myocardial ischemia was directly linked to fluctuating thyroid hormone levels.
Implications:
- Assessing thyroid status is crucial for patients with unexplained coronary vasospasm.
- Understanding this connection can improve diagnosis and management of cardiac events in hyperthyroid patients.
Abstract:
While angina is not uncommonly seen in association with hyperthyroidism, only rare case reports have suggested that myocardial ischemia in this state may be due to coronary artery spasm. The authors review the literature and describe a case in which the repetitive occurrence of episodes of myocardial ischemia due to coronary spasm correlated with repeated transient elevations in thyroid hormone levels, thus clarifying this relationship. The importance of defining thyroid status in patients presenting with coronary vasospasm is emphasized and the effects of thyroid hormone on the heart are reviewed.