Key result
Thymectomy reversed pseudoischemic ECG changes in a patient with myasthenia gravis and thymoma, highlighting that MG can mimic myocardial ischemia.
Case Report (n=1)
Myasthenia gravis with thymoma can present with pseudoischemic ECG changes and CK elevations that reverse after thymectomy, highlighting the importance of considering noncoronary disorders in the differential diagnosis of myocardial ischemia.
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Consider MG in unexplained pseudoischemic ECGs; single case leaves open broader applicability of thymectomy.
Abnormal ST T-wave changes can be found at presentation in various noncoronary disorders; misinterpretation of these patterns as ischemic heart disease can lead to erroneous diagnosis and treatment. Here we present a case of myasthenia gravis (MG) with thymoma, in which the resting electrocardiogram (ECG) led to a misleading diagnosis of myocardial ischemia. After thymectomy, the ECG resumed a normal pattern. Myasthenia gravis is not usually considered in the differential diagnosis of conditions associated with an abnormal ECG. The combination of dysphagia, dyspnoea, ECG changes, and creatine kinase (CK) elevations may easily bring to mind an erroneous and possibly deleterious diagnosis of myocardial ischemia.
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Chiavistelli et al. (2009) conducted a case report in Myasthenia gravis with thymoma (n=1). Thymectomy was evaluated on ECG pattern reversibility. Thymectomy reversed pseudoischemic ECG changes in a patient with myasthenia gravis and thymoma, highlighting that MG can mimic myocardial ischemia.
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