[Takotsubo syndrome and hyperthyroidism: a case report]

A Irigaray Echarri1, A Ernaga Lorea, N Eguilaz Esparza

  • 1Servicio de Endocrinología y Nutrición. Complejo Hospitalario de Navarra. Pamplona.. anairigarayecharri@gmail.com.

Insights

Stress cardiomyopathy (Takotsubo syndrome) mimics heart attacks but lacks blocked arteries. This case highlights hyperthyroidism as a potential trigger for Takotsubo syndrome, emphasizing the need for identifying predisposing factors.

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.

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