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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
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STEMI after Dobutamine Stress Echocardiography in Hyperthyroid State.

Mahmood Mubasher1, Ashfaq Patel1, Mohamed Magdi1

  • 1Hamad Medical Corporation, Qatar.

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Severe hyperthyroidism can impact cardiovascular health, leading to unexpected cardiac events. This case highlights a patient experiencing myocardial infarction during a stress test despite mild coronary artery disease.

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Area of Science:

  • Cardiology
  • Endocrinology
  • Cardiovascular Physiology

Background:

  • Uncontrolled hyperthyroidism significantly alters cardiovascular hemodynamics.
  • Thyroid storm and thyrotoxicosis can precipitate acute cardiovascular events.
  • The interplay between hyperthyroidism and coronary artery disease requires careful evaluation.

Observation:

  • A 39-year-old male with newly diagnosed severe hyperthyroidism presented with symptoms of stable angina.
  • The patient underwent dobutamine stress echocardiography (DSE) for cardiac evaluation.
  • During the DSE, the patient experienced an ST-segment elevation myocardial infarction (STEMI).

Findings:

  • Coronary angiography revealed only mild coronary artery disease.
  • The STEMI in this context suggests a potential link to the severe hyperthyroid state.
  • Hemodynamic changes induced by hyperthyroidism may have contributed to the ischemic event.

Implications:

  • This case underscores the critical need to recognize and manage hyperthyroidism in patients with cardiovascular symptoms.
  • Severe hyperthyroidism can unmask or exacerbate underlying coronary artery disease, leading to acute coronary syndromes.
  • Further research is warranted to elucidate the mechanisms linking hyperthyroidism to myocardial infarction in the absence of significant coronary atherosclerosis.