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Variant angina in thyrotoxicosis

P S Phull1, C E Collins, M S Norell

  • 1Department of Medicine, Mount Vernon Hospital, Northwood, Middlesex.

The British Journal of Clinical Practice
|January 1, 1993
PubMed
Summary

Thyrotoxicosis can cause angina in women, even with healthy coronary arteries. Treating the thyroid condition resolved chest pain, suggesting a link between thyroid function and cardiac symptoms.

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Area of Science:

  • Cardiology
  • Endocrinology

Background:

  • Thyrotoxicosis (overactive thyroid) can worsen existing coronary artery disease.
  • Angina symptoms, or chest pain, can also occur in thyrotoxic patients without coronary artery disease.

Observation:

  • Four severely thyrotoxic women presented with angina as a primary symptom.
  • Two patients showed transient electrocardiogram (ECG) abnormalities during chest pain episodes.
  • All patients had normal exercise ECGs and one had a normal coronary angiogram.

Findings:

  • Thyroid function treatment immediately relieved chest pain in all patients.
  • The angina did not recur after treatment for thyrotoxicosis.
  • This suggests thyrotoxicosis can directly cause angina, potentially via coronary artery spasm or altered myocardial metabolism.

Implications:

  • Thyroid function testing is recommended for young women presenting with atypical angina.
  • Understanding this link can improve diagnosis and management of cardiac symptoms in thyrotoxic patients.

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