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Unexpected case of Graves` disease induced myocarditis: a case report

Widya Safitri1, Dian Yaniarti Hasanah1, Celly Anantaria Atmadikoesoemah2

  • 1Division of Clinical Cardiology, Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita.

Cardiovascular Endocrinology & Metabolism
|January 12, 2024
PubMed

Insights

Graves' disease can rarely cause myocarditis, mimicking heart attacks. Prompt diagnosis and treatment of this hyperthyroidism complication significantly improve patient outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Graves' disease, an autoimmune disorder, can rarely manifest with cardiac complications.
  • Myocarditis, inflammation of the heart muscle, can present with symptoms mimicking acute coronary syndrome.

Observation:

  • A 50-year-old woman presented with symptoms of a high-risk myocardial infarction, new atrial fibrillation, and acute heart failure.
  • Coronary angiography was normal, but cardiac MRI revealed intra-myocardial late gadolinium enhancement, indicating myocarditis.
  • Thyroid evaluation showed nodules and elevated thyrotropin receptor antibodies, confirming Graves' disease.

Findings:

  • The patient was diagnosed with myocarditis secondary to Graves' disease.
  • Treatment with Propylthiouracil and guideline-directed medical therapy for heart failure led to clinical improvement.

Implications:

  • This case highlights the importance of considering Graves' disease in patients presenting with unexplained myocarditis.
  • Early recognition and management of hyperthyroidism-induced myocarditis are crucial for favorable patient outcomes.
  • Understanding the link between hyperthyroidism and cardiac inflammation can improve diagnostic and therapeutic strategies.

Keywords:
Graves` diseaseacute coronary syndromeheart failuremyocarditis

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