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Vasospastic angina in thyrotoxicosis--case reports.

T Nakano1, T Konishi, H Takezawa

  • 1First Department of Internal Medicine, Mie University School of Medicine, Japan.

Angiology
|September 1, 1987
PubMed
Summary

Thyrotoxicosis can cause angina by inducing coronary artery spasm, even without pre-existing heart disease. Treating thyroid hormone excess resolves this chest pain, suggesting a direct link between thyroid function and coronary artery sensitivity.

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Area of Science:

  • Cardiology
  • Endocrinology
  • Thyroidology

Background:

  • Thyrotoxicosis, a condition of excess thyroid hormone, can manifest with various cardiovascular symptoms.
  • Angina, or chest pain due to reduced blood flow to the heart, is typically associated with coronary artery disease.
  • The relationship between thyrotoxicosis and angina, particularly in the absence of significant coronary artery disease, requires further elucidation.

Observation:

  • Two patients presented with thyrotoxicosis and concurrent progressive angina.
  • Electrocardiogram (ECG) showed ST segment elevation in one patient and depression in the other during angina episodes.
  • Coronary arteriography revealed normal findings at baseline, but ergonovine administration induced coronary artery spasm.

Findings:

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  • Coronary artery spasm was successfully induced by ergonovine in patients with thyrotoxicosis-associated angina.
  • Following successful treatment of thyrotoxicosis, patients experienced complete resolution of chest pain, even without antianginal medications.
  • These findings suggest that thyroid hormone excess can render coronary arteries susceptible to spasm.

    • Implications:

    • Thyroid hormone excess may increase coronary artery sensitivity to spasm, independent of significant coronary artery disease.
    • This highlights the importance of considering and managing thyrotoxicosis in patients presenting with unexplained angina.
    • Early diagnosis and treatment of thyrotoxicosis can potentially prevent or resolve angina episodes related to coronary artery spasm.