Hyperthyroidism presenting as ST Elevation Myocardial Infarction with Normal Coronaries - A Case Report

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Chest pain is a common presenting symptom requiring urgent diagnosis.
• Myocardial infarction is a primary concern, but other conditions can mimic its presentation.

Observation:

• A 31-year-old male presented with typical chest pain and ECG changes suggestive of myocardial infarction.
• Echocardiogram showed anteroseptal hypokinesia with reduced ejection fraction.
• Coronary angiography revealed normal coronary arteries.
• Thyroid function tests indicated hyperthyroidism (elevated free T4, suppressed TSH).

Findings:

• Hyperthyroidism-induced cardiomyopathy can present with symptoms mimicking acute coronary syndrome.
• Treatment with thionamides and beta-blockers led to symptom resolution.
• Cardiac function, assessed by echocardiogram, normalized after thyroid hormone levels were controlled.

Implications:

• Thyroid dysfunction should be considered in the differential diagnosis of patients presenting with cardiac symptoms, especially in the absence of coronary artery disease.
• Effective management of hyperthyroidism can reverse cardiac dysfunction.
• This case underscores the critical link between thyroid health and cardiovascular well-being.