Abstract
Thyroid hormone has a major role in cardiovascular function and cardiac hemodynamics. A slight change in thyroid affects ventricular function, serum cholesterol levels, increases the risk of coronary artery disease as well as cardiovascular mortality. In this report, we present a 62-year-old female with history significant for ischemic heart disease who was admitted for acute coronary syndrome (ACS) with persistent tachycardia, requiring urgent cardiac catheterization. Complete cardiac workup revealed that the patient had most likely suffered from vasospastic angina secondary to inadvertent overdose of her prescribed levothyroxine. This report emphasizes the significant cardiac complications caused by a deluged hyperadrenergic state secondary to overt hyperthyroidism. We conclude that thyrotoxicosis is a significant risk factor for cardiovascular disease and should be considered as a cause of life-threatening myocardial ischemia, especially in patients with known ischemic heart disease and thyroid disorders.
Highlights
Acute coronary syndrome (ACS) in the setting of hyperthyroidism is a well-described phenomenon; evaluation of thyroid function is quite often overlooked when assessing cardiovascular risk factors
[1] Overt hyperthyroidism is characterized by low serum thyroid-stimulating hormone (TSH) concentrations and raised serum concentrations of thyroid hormones: thyroxine (T4), triiodothyronine (T3), or both
[2] We describe a case of a patient admitted to the cardiac intensive care unit (CICU) for ACS in the setting of overt thyrotoxicosis and known ischemic heart disease
Summary
Acute coronary syndrome (ACS) in the setting of hyperthyroidism is a well-described phenomenon; evaluation of thyroid function is quite often overlooked when assessing cardiovascular risk factors. Thyroid hormone has important effects on cardiac muscle, the peripheral circulation, and the sympathetic nervous system that alter cardiovascular hemodynamics in a predictable way. [1] Overt hyperthyroidism is characterized by low serum thyroid-stimulating hormone (TSH) concentrations and raised serum concentrations of thyroid hormones: thyroxine (T4), triiodothyronine (T3), or both. [2] We describe a case of a patient admitted to the cardiac intensive care unit (CICU) for ACS in the setting of overt thyrotoxicosis and known ischemic heart disease. Focuses on the clinical importance of evaluation of thyroid function as an independent risk factor for cardiovascular disease, in patients with known, or at risk of thyroid disease
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