Thyroid Storm-induced Takotsubo Cardiomyopathy Presenting as Acute Chest Pain: A Case Report
Brayden Ashdown1, Emilie Calvello Hynes2
1Denver Health, Department of Emergency Medicine, Denver, Colorado.
Insights
Thyroid storm can induce stress-induced cardiomyopathy, a serious heart condition mimicking heart attacks. Early recognition and distinct therapies are crucial for patients presenting with chest pain.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Stress-induced cardiomyopathy (SIC) presents with chest pain and carries high in-hospital mortality, comparable to acute ST-elevation myocardial infarction.
- The underlying pathophysiology of SIC is attributed to excessive catecholamine effects on the heart muscle.
Purpose of the Study:
- To report a case of stress-induced cardiomyopathy secondary to thyroid storm.
- To highlight the importance of considering thyrotoxicosis in the differential diagnosis of SIC.
Main Methods:
- A case report of a previously healthy female presenting with acute chest pain.
Main Results:
- The patient was diagnosed with thyroid storm-induced cardiomyopathy exhibiting a typical SIC pattern.
- Coronary angiography revealed no evidence of coronary artery disease.
Conclusions:
- Thyrotoxicosis can lead to catecholamine dysregulation and is a rare cause of SIC.
- Emergency physicians should consider thyroid storm in the workup of chest pain suggestive of SIC, as it requires specific treatment approaches.
Introduction:
Stress-induced cardiomyopathy is a rare but serious cause of chest pain, which in recent studies has been shown to carry a similar in-hospital mortality to acute ST-elevation myocardial infarction. The pathophysiology of the disease is thought to be secondary to dysregulated catecholamine effects on myocardium.
Case Report:
We present a case of a previously healthy female without known thyroid disease who presented to the emergency department for acute chest pain and was found to have thyroid storm-induced cardiomyopathy in a typical stress-induced cardiomyopathy pattern without evidence of coronary disease on catheterization.
Conclusion:
Thyrotoxicosis can cause dysregulation of catecholamines and is a rare cause of stress-induced cardiomyopathy. It requires distinct therapies and should be considered by emergency physicians in the workup of acute chest pain with concern for stress-induced cardiomyopathy.
