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Coronary artery spasm due to thyrotoxicosis
The New Zealand Medical Journal
|February 7, 2013
Summary
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.
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