Key result
Graves' disease may induce silent MI despite angiographically normal coronary arteries.
Why the study?
The mechanism by which Graves' disease may cause myocardial infarction without coronary artery disease is not well understood.
Case Report (n=1)
Graves' disease may cause reversible cardiomyopathy without CAD; leaves open whether thyroid screening alters outcomes in new-onset HF.
A 45-year-old female without coronary risk factors showed a 20 kg decrease in body weight, hyperhydrosis, palpitations and dyspnea on exertion for 2 months, and nocturnal dyspnea for 1 month before admission. She did not notice chest pain indicative myocardial infarction or fever suggestive myocarditis. Graves' disease was confirmed by exophthalmos and elevated titers of T3 and T4 thyroid hormones. Cardiac catheterization studies demonstrated no significant coronary artery disease but showed akinesis of the anteroseptal and apical walls which suggested myocardial infarction. Thyroid hormone may directly influence myocardial oxygen supply and demand and, by some unknown mechanism, cause a critical imbalance in coronary circulation resulting in myocardial infarction.
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Nakano et al. (1987) conducted a case report in Myocardial infarction and Graves' disease (n=1). Graves' disease was evaluated. A 45-year-old female with Graves' disease developed an asymptomatic myocardial infarction despite having normal coronary arteries, indicating thyrotoxicosis may induce critical coronary ischemia.
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