Introduction. Hyperthyroidism is a condition associated with excessive production of thyroid hormones, thyroxine and triiodothyronine. The adverse effects on the cardiovascular system are myocardial ischemia, rhythm disturbances, cardiomyopathy, heart failure and sudden death. The presented clinical case describes the development of type 2 acute anterior myocardial
infarction with ST- elevation complicated by heart failure in a patient with hyperthyroidism.
Case presentation. A 76-year-old patient with late-diagnosed hyperthyroidism complicated by dilated cardiomyopathy was urgently admitted to the cardiology department because of typical angina and shortness of breath. The electrocardiogram demonstrated an acute anterior ST-elevation myocardial infarction. Echocardiography revealed increased left ventricular volumes, severely depressed systolic function with ejection fraction 15% by Simpson’s method, severe mitral regurgitation and wall-motion abnormalities. Percutaneous coronary intervention revealed underlying atherosclerotic disease without acute thrombosis.
Conclusions. The clinical case illustrates the rarer possibility of developing an acute coronary syndrome because of an imbalance between oxygen demand and available coronary flow in another underlying disease, as opposed to type 1 myocardial infarction, which is the most common. There is a need for screening of cardiovascular complications of thyroid disorders.
Keywords: thyrotoxicosis, myocardial ischemia, dilated cardiomyopathy, heart failure, atrial fibrillation.
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Nevena G. IVANOVA
St Karidad MBAL, Karidad Medical Health Center, Cardiology, Plovdiv, Bulgaria.
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