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Related Experiment Videos

Factitious hyperthyroidism causing acute myocardial infarction

G J Locker1, H Kotzmann, B Frey

  • 1Department of Internal Medicine I, University of Vienna, Austria.

Thyroid : Official Journal of the American Thyroid Association
|December 1, 1995
PubMed
Summary
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Sudden increases in levothyroxine dose can cause myocardial infarction in patients with hypothyroidism. Careful dose adjustment is crucial to prevent this severe complication.

Area of Science:

  • Cardiology
  • Endocrinology

Background:

  • Thyroid hormone replacement therapy is common for hypothyroidism.
  • Levothyroxine is a standard treatment for hypothyroidism following thyroidectomy.

Observation:

  • A 71-year-old woman developed myocardial infarction after a levothyroxine dose increase.
  • The patient had no prior history of coronary artery disease.
  • Coronary arteriograms showed no significant vessel disease.

Findings:

  • Myocardial scintigraphy revealed a persistent perfusion defect post-infarction.
  • Thyrotoxicosis factitia, induced by the levothyroxine dose escalation, is the suspected cause.
  • Increased thyroid hormone levels heighten myocardial oxygen demand.

Implications:

Related Experiment Videos

  • This case highlights the risk of myocardial infarction from rapid levothyroxine dose increases.
  • Clinicians should exercise caution when adjusting levothyroxine dosages.
  • Sudden dose elevations can precipitate severe cardiac events in susceptible individuals.