Hyperthyroidism presenting as ST Elevation Myocardial Infarction - A Case Report

Krishnan, Gayathri Devi; Yahaya, Norhayati; Yahya, Mansor

doi:10.15605/jafes.034.01.14

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Hyperthyroidism is proved as a higher risk to develop myocardial infraction (MI) causing thyrocardiac disease, which is similar to the other case studies. [21,22] In this research study, two factors are investigated including gender in female and age group of 19-39 for higher risk of suffering from thyrocardiac disease to develop MI. In terms of gender, female is more likely to suffer from hyperthyroidism than male, having higher chance to develop MI.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Thyrocardiac Disease among Patients with Hyperthyroidism in Hong Kong

LAU¹,

Fung

Mok

et al. 2022

Preprint

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This research aims to investigate the association between hyperthyroidism and age, sex, and infraction of the myocardium in the Hong Kong population to detect hyperthyroidism-induced infraction earlier (e.g., thyrocardiac disease) through chemiluminescent microparticle immunoassay (CMIA). A total of 7616 random blood specimens from males and females were collected and examined by Architect i immunoassay platform to obtain quantitative laboratory values of Free FT4, TSH, and hs-cTnI in samples serum differentiating into overt and subclinical hyperthyroidism cases. The age was between 19 and 81 years old. In this research, for population characteristics, 57 cases confirmed as hyperthyroidism (e.g. FT4 > 1.48 ng/dL, according to Abbott's suggested reference interval) were used for analysis and 22 cases were examined in the laboratory. The highest number of hyperthyroidism, including overt and subclinical cases in females, was 43 (75.44%), rather than males. For prevalence data of hyperthyroidism between September 2019 to January 2020 in Hong Kong, the range was from 0.62% to 0.93% (Median percentage = 0.75%). The research will explore the in-depth impact of gender differences on thyrocardiac disease, the risk of thyrocardiac disease by age group, and the possible relationship between FT4 and hs-cTnI.

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Section: Discussionmentioning

confidence: 99%

Pattern of Thyrocardiac Disease among Patients with Hyperthyroidism in Hong Kong

LAU¹,

Fung

Mok

et al. 2022

Preprint

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“…In a community dwelling elderly population, low fT3 was linked to low muscle mass and poor physical ability (35). In MINOCA patients, two recent case studies have shown that thyroid diseases such as thyrotoxicosis may be a potential cause for MINOCA, suggesting that thyroid hormones may play an important role in the pathogenesis of MINOCA and may have an impact on the prognosis of such patients group (36,37). To the best of our knowledge, this is the first study to demonstrate a relationship between lower fT3 levels and increased risk of MACE and cardiovascular deaths in the MINOCA population.…”

Section: Discussionmentioning

confidence: 99%

Low Free Triiodothyronine as a Predictor of Poor Prognosis in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries

et al. 2021

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BackgroundLow free triiodothyronine (fT3) level is strongly associated with poor prognosis in various patient populations. However, the role of fT3 in the risk of clinical outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA) has not been studied. Our study aimed to evaluate the association between low fT3 levels and the clinical outcomes of MINOCA patients.MethodsA total of 218 MINOCA patients without a history of thyroid disease were enrolled in the study. Demographic, baseline clinical data, thyroid hormones, and other biochemical parameters were assessed in all patients. According to the fT3 levels, the present study was classified into two groups: the low fT3 group (fT3<3.5 pmol/L) and the normal fT3 group (fT3 3.5-6.5 pmol/L). The endpoint of the study was major adverse cardiac events (MACE).ResultsFifty-nine patients were in the low fT3 group and 159 patients were in the normal fT3 group. Over the two years of follow-up, 36 MACE have occurred. The occurrence of MACE was higher in the low fT3 group compared with normal fT3 group (25.4% vs 13.2%; P=0.031). Kaplan-Meier survival curves showed a significantly increased risk of MACE in patients with low fT3 (log-rank P=0.027). Multivariable logistic regression analysis stated that high fT3 was independently associated with lower risk of MACE after two years of follow up (OR, 0.623; 95% CI, 0.399- 0.972; P=0.037).ConclusionLow fT3 levels were significantly associated with increased risk of MACE in patients with MINOCA. This finding suggests that the fT3 levels may serve as a potential biomarker in risk stratification of MINOCA patients.

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“…Most cases of thyrotoxicosis are linked with Graves' disease and toxic nodular goiter [ 67 ]. Hyperthyroidism is widely documented to be linked to cardiovascular disease [ 68 ]. Fatal disorders such as acute myocardial infraction presentation might be present in patients suffering from thyrotoxicosis, as seen in one case report, in which the patient presented with elevated ST segments in leads II, III, and aVF, as well as pressure-like chest discomfort and an increased troponin level.…”

Section: Reviewmentioning

confidence: 99%

ST-Segment Elevation in Conditions of Non-cardiovascular Origin Mimicking an Acute Myocardial Infarction: A Narrative Review

Khurana¹,

Ranjan²

2022

Cureus

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The most widespread presenting ailments among patients visiting the emergency department are chest pain and shortness of breath. These symptoms lead any doctor to a probable diagnosis of myocardial infarction (MI). Detailed patient history, testing of blood samples for cardiac biomarkers that are indicative of cardiovascular necrosis, ultrasound methods, electrocardiography, and coronary computed tomography (CT) could all be beneficial to support the diagnosis. Out of these, electrocardiography is the most important and commonly done investigation in the emergency departments for patients presenting with chest pain and shortness of breath. However, interpreting these patients' electrocardiograms (ECGs) may be a matter of concern and worry. T wave and ST-segment changes are often of interest in the early signs of myocardial ischemia. Despite its incredible sensitivity, ST-segment deviation (elevated or depressed) has a low specificity because it can be seen in a variety of other cardiac and non-cardiac diseases. When ST-segment anomalies are identified, clinicians must consider many additional characteristics (such as risk factors, symptoms, and anamnesis), as well as all other possible diagnoses.All of these scenarios of patients presenting in the emergency department with chest discomfort and shortness of breath showing ST-segment abnormalities can leave a healthcare professional wondering whether to start treatment for acute myocardial infarction, through either the administration of a fibrinolytic agent, exposing patients to both the benefits and risks of fibrinolysis, or invasive coronary angiography. An astute physician may be able to recognize fabricated differential diagnosis mimicking STsegment elevation myocardial infarction (STEMI) in some situations. Failure to recognize these imposters can result in inefficient resource utilization, which can expose patients to unjustified risk and increased rather than decreased death and morbidity. Since the danger of cerebral hemorrhage from blood thinners is significant, in patient-care scenarios, in order to rule out percutaneous coronary intervention (PCI), a thorough assessment of the ECG is essential to consider diseases other than acute myocardial infarction, especially the ones that are non-cardiac in origin. The goal of this narrative review is to give an overview of the significant disorders that are non-cardiac in origin that can mimic an ST-segment elevation myocardial infarction (STEMI).

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Hyperthyroidism presenting as ST Elevation Myocardial Infarction - A Case Report

Cited by 3 publications

References 7 publications

Pattern of Thyrocardiac Disease among Patients with Hyperthyroidism in Hong Kong

Pattern of Thyrocardiac Disease among Patients with Hyperthyroidism in Hong Kong

Low Free Triiodothyronine as a Predictor of Poor Prognosis in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries

ST-Segment Elevation in Conditions of Non-cardiovascular Origin Mimicking an Acute Myocardial Infarction: A Narrative Review

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