A case of myocardial infarction in a young female with subclinical hyperthyroidism

Abstract

In forensic practices, cases of sudden unexpected death are often encountered, and the clarification of the cause of death is always required. Ischemic heart disease such as acute myocardial infarction is the most frequent as the cause of sudden unexpected internal death [1]. Moreover, endocrinological disorder is closely related with sudden unexpected death [1–3]. In particular, thyrotoxicosis is well known as the cause of sudden unexpected death [4–8]. Recently, several lines of accumulating evidence demonstrated that thyroid dysfunction increased the risk of cerebral vascular diseases [9] and ischemic heart diseases [10–12]. Herewith, we report a case of acute myocardial infarction in a young female with untreated hyperthyroidism. In the morning of one day, a 25-year-old female consulted to a neighbor clinic, because of her pericardial pain about 9:00 AM. There were no significant findings in both electrocardiogram and blood chemistry. Shewasmedicated with analgesics and sedatives (pentazocine and diazepam) at 9:15 and 9:30 AM and her condition seemed to be better, under the observation in the clinic. However, at 10:40 AM, she suddenly suffered cardiopulmonary arrest, and then shewas immediately intubated and then conveyed to an emergency hospital by an ambulance (arrival at 11:08 AM). Despite intensive care treatment, her death was confirmed at 0:35 PM. According to her mother, she had suffered from hyperthyroidism, and been medicated with propylthiouracil (an antithyroid). However, she often forgot to take the medicine, and never consulted to her thyroidologist for the past two