[Takotsubo syndrome and hyperthyroidism: a case report]

Area of Science:

• Cardiology
• Endocrinology

Background:

• Stress cardiomyopathy, or Takotsubo syndrome, presents with symptoms mimicking acute coronary syndrome, including ECG changes and elevated troponin, but typically shows no obstructive coronary lesions.
• Regional wall motion abnormalities on echocardiography are characteristic of Takotsubo syndrome.
• Thyroid disorders have been associated with Takotsubo syndrome, though the underlying mechanism remains unclear.

Observation:

• A case study of a woman presenting with acute chest pain, electrocardiographic abnormalities, and elevated troponin levels was observed.
• Severe ventricular dysfunction was detected via echocardiography, with coronary arteriography revealing no obstructive lesions, consistent with Takotsubo syndrome.
• The patient was diagnosed with hyperthyroidism due to Graves' disease, identified as the likely trigger for the Takotsubo syndrome.

Findings:

• The presented case confirms the association between hyperthyroidism and Takotsubo syndrome.
• Echocardiography revealed significant ventricular dysfunction, a hallmark of Takotsubo syndrome.
• Coronary angiography excluded obstructive coronary artery disease, differentiating it from typical myocardial infarction.

Implications:

• Identifying and managing clinical factors, such as hyperthyroidism, that may predispose patients to Takotsubo syndrome is crucial.
• Understanding triggers like Graves' disease can improve the management and outcomes for patients with Takotsubo syndrome.
• This case underscores the importance of considering endocrine disorders in the differential diagnosis of patients presenting with symptoms suggestive of acute coronary syndrome.