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Thyrotoxicosis-induced prinzmetal variant angina
1Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital of Zürich, Switzerland. vojtech.pavlicek@usz.ch
Summary
Thyrotoxicosis from Graves' disease can cause variant angina in postmenopausal women. Restoring normal thyroid function effectively resolved symptoms and improved exercise capacity, suggesting a curative approach.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Variant angina, characterized by chest pain due to coronary artery spasm, can be triggered by various conditions.
- Thyrotoxicosis, a state of excessive thyroid hormone production, can manifest with diverse cardiovascular symptoms.
Observation:
- A postmenopausal woman presented with new-onset variant angina during exercise, exhibiting ST segment elevation on ECG.
- Coronary angiography revealed normal coronary arteries, ruling out obstructive coronary artery disease.
Findings:
- The patient was diagnosed with Graves' disease, an autoimmune disorder causing hyperthyroidism.
- Treatment with propylthiouracil normalized thyroid hormone levels (euthyroid state).
- Following treatment, angina symptoms resolved completely, and exercise capacity normalized without ECG abnormalities.
Implications:
- This case highlights the potential link between thyrotoxicosis and variant angina with normal coronary arteries.
- Restoration of normal thyroid function may be a curative strategy for variant angina in the context of hyperthyroidism.
- Clinicians should consider thyroid dysfunction in the differential diagnosis of patients presenting with unexplained angina and normal coronary arteries.
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