Related Experiment Video

Updated: May 14, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

Coronary artery spasm due to thyrotoxicosis

Krystina Common, Kry S Milburn, Tom S Cawood

    The New Zealand Medical Journal
    |February 7, 2013
    PubMed

    Insights

    This case study shows that hyperthyroidism, specifically Graves' disease, can cause chest pain and ECG changes due to coronary artery spasm, even with normal arteries. Prompt treatment of the thyroid condition resolved the symptoms.

    Area of Science:

    • Cardiology
    • Endocrinology

    Background:

    • Thyrotoxicosis, particularly Graves' disease, can manifest with cardiovascular symptoms.
    • Chest pain with ST elevation on ECG typically suggests acute coronary syndrome.

    Observation:

    • A 50-year-old female presented with chest pain, tremor, weight loss, and ECG abnormalities indicative of myocardial injury.
    • Coronary angiography revealed normal coronary arteries, ruling out obstructive coronary artery disease.

    Findings:

    • The patient was diagnosed with Graves' disease, a form of hyperthyroidism.
    • Coronary artery spasm secondary to thyrotoxicosis was identified as the cause of her ischemic symptoms and ECG changes.
    • Treatment with diltiazem, metoprolol, and carbimazole led to successful symptom resolution.

    Implications:

    • This case underscores the importance of considering hyperthyroidism as a potential cause of chest pain and ECG changes in patients with normal coronary arteries.
    • Early diagnosis and management of thyrotoxicosis are crucial for preventing and treating cardiac manifestations like coronary artery spasm.
    • Clinicians should maintain a high index of suspicion for endocrine disorders in patients presenting with unexplained cardiac symptoms.

    More Related Videos

    Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

    Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

    Published on: September 17, 2021

    Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

    Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

    Published on: February 3, 2021

    Related Concept Videos

    Hyperthyroidism I: Introduction01:25

    Hyperthyroidism I: Introduction

    Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
    Hyperthyroidism II: Pathophysiology01:27

    Hyperthyroidism II: Pathophysiology

    Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
    Graves Disease II: Pathophysiology01:24

    Graves Disease II: Pathophysiology

    Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
    Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

    Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

    The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
    Angina I: Introduction01:30

    Angina I: Introduction

    Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...
    Coronary Artery Disease III: Clinical Manifestations01:30

    Coronary Artery Disease III: Clinical Manifestations

    Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...