Hyperthyroidism presenting as ST Elevation Myocardial Infarction with Normal Coronaries - A Case Report
Gayathri Devi Krishnan1, Norhayati Yahaya1, Mansor Yahya1
1Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia.
Journal of the ASEAN Federation of Endocrine Societies
|January 14, 2021
Summary
Thyrotoxicosis can mimic heart attack symptoms, causing chest pain and reduced heart function. Prompt treatment of hyperthyroidism resolved cardiac issues, highlighting the importance of thyroid evaluation in cardiac emergencies.
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.
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