Unexpected Grave’s-induced acute myocardial
infarction in a young female, a literature
review based on a case report

Unexpected Grave’s-induced acute myocardial
infarction in a young female, a literature
review based on a case report

Myocardial ischemia, Hyperthyroidism, Acute coronary syndrome, Interventional cardiology, Case report

Abstract
Introduction Myocardial ischemia can occur due to several causes, which result in an imbalance between the supply
and demand of oxygen to cardiac muscles. One potential reason for this condition is the overwork of the heart due to
hyperstimulated thyroid function.
Case presentation The patient was a 36-year-old woman who presented with left-sided chest pain, dyspnea,
palpitation, and tremor. The initial evaluation showed evidence of myocardial ischemia (positive high-sensitivity
troponin) caused by a hyperactive thyroid gland. The treatment for myocardial infarction, along with anti-thyroid
medications, improved the patient’s condition and subsided the symptoms. The coronary angiography revealed no
pathologic finding, and the hypokinetic left ventricle, observed in the first echocardiogram, was resolved. The patient
was discharged with an excellent clinical condition, and after the 4-month taking of a calcium channel blocker and
tapering carbimazole, the thyroid function became normal, and her symptoms resolved completely.
Conclusion Patients without evident risk factors for ischemic heart disease, such as non-diabetic, nonsmoker, and
young individuals who presented with acute coronary syndrome, should be evaluated for a potential background
reason for the imbalance between the oxygen demand and supply of the myocardium. The presence of palpitation,
weight loss, tremors, insomnia, and anxiousness, along with ischemic signs, should make the physician think about
the probability of the hyperthyroid-induced cardiovascular disorder.
Clinical key point The initial presentation of hyperthyroidism might be accompanied by severe cardiac symptoms.
When the demographic features are not aligned with usual ischemic heart disease, other probable symptoms and
signs should be investigated, and thyroid function should be checked. The control of thyroid hyperactivity would
result in the resolution of both cardiac and non-cardiac symptoms.
Keywords Myocardial ischemia, Hyperthyroidism, Acute coronary syndrome, Interventional cardiology, Case report

Fatemeh Naderi1*, Narges Naderi2

, Seyedeh Maryam Mousavinezhad3

and Amin Zaki Zadeh3

https://doi.org/10.1186/s12245-024-00695-1

2024

Peri Irawan

pdf

english

text