Acute ST-Elevation Myocardial Infarction in Patient with Severe Uncontrolled Hyperthyroidism Complicated by Thyroid
Khaled Al Khodari1, Raad Alhaj Tahtouh2, Tahir Hamid1
1Department of Cardiology, Hamad Medical Corporation, Doha, Qatar.
Heart Views : the Official Journal of the Gulf Heart Association
|January 6, 2023
Summary
Thyroid storm can mimic acute myocardial infarction, presenting with chest pain and ECG changes. Prompt medical management for both conditions is crucial for patient recovery.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Thyroid storm (TS) is a severe endocrine emergency associated with uncontrolled hyperthyroidism.
- Cardiovascular complications are common in TS, but ST-elevation myocardial infarction (STEMI) is a rare presentation.
Observation:
- A 40-year-old male with known hyperthyroidism presented with chest pain, tachycardia, and ECG changes suggestive of STEMI.
- Initial presentation included atrial fibrillation and ST-segment elevation, with very high thyroxine (T4) and undetectable TSH levels.
Findings:
- The patient initially refused coronary revascularization, receiving medical treatment for both TS and acute coronary syndrome.
- Coronary angiography revealed embolic occlusion of the left anterior descending artery, treated successfully with anticoagulation.
- Chest pain and thyroid function normalized with combined cardiology and endocrinology care.
Implications:
- This case highlights the importance of considering TS in patients presenting with STEMI-like symptoms and hyperthyroidism.
- Early medical management can be effective even when coronary revascularization is initially declined.
- Integrated care between cardiology and endocrinology is vital for managing complex cases involving both acute coronary syndrome and thyroid emergencies.
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