A Case of Vasospastic Angina Possibly Triggered by Hyperthyroidism

A 55-year-old man experienced chest tightness once a month. After half a year, he was admitted to our hospital for a thorough examination due to frequent chest symptoms and was diagnosed with vasospastic angina (VSA) following an ergonovine stress test on coronary angiography. The patient also had hyperthyroidism, which led to a diagnosis of Graves' disease. In this case, the patient did not exhibit typical hyperthyroid symptoms such as goiter, palpitations, excessive sweating, or finger tremors. However, the timing of weight loss coincided with an increase in the frequency of chest pain episodes, suggesting that hyperthyroidism may have contributed to the onset of VSA. Since hyperthyroidism has been reported to be a risk factor for VSA and its coexistence is known to increase the risk of severe coronary spasm, thyroid function should be evaluated aggressively in patients suspected of having VSA.