Clinical Characteristics of Thyrotoxicosis Presented by Coronary Spasm.
10.11106/jkta.2013.6.1.64
- Author:
Kiwon KIM
1
;
Se Whan LEE
;
Sung Wan CHUN
;
Yeo Joo KIM
;
Sang Jin KIM
Author Information
1. Division of Endocrinology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. yeojoo@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
Thyrotoxicosis;
Coronary vasospasm
- MeSH:
Arteries;
Cardiac Output;
Chest Pain;
Coronary Angiography;
Coronary Artery Disease;
Coronary Stenosis;
Coronary Vasospasm;
Coronary Vessels;
Diagnostic Tests, Routine;
Female;
Follow-Up Studies;
Humans;
Male;
Myocardial Ischemia;
Spasm;
Thorax;
Thyroid Function Tests;
Thyroid Gland;
Thyroiditis;
Thyrotoxicosis
- From:Journal of Korean Thyroid Association
2013;6(1):64-68
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Cardiovascular symptoms are integral and often the most predominant clinical presentation in patients with thyrotoxicosis. In patients with known or suspected coronary artery disease, myocardial ischemia and angina-like chest pain may be presented due to increase in cardiac output and cardiac contractility as a result of thyrotoxicosis. In addition, coronary spasm may result in angina-like chest pain in thyrotoxicosis patients without any fixed coronary artery stenosis. However, there are few reports about clinical characteristics of thyrotoxicosis associated with coronary artery spasm. MATERIALS AND METHODS: Coronary angiography, thyroid function test, and follow-up clinical data of patients were analyzed retrospectively. RESULTS: Twelve patients with coronary artery spasm were included over 4.5 years (male:female, 5:7). The mean age of patients was 53.3 years (range, 27 to 68), and female patients were younger than male patients (mean, 56.2 vs. 51.2 years). Only 4 patients (33%) presented typical thyrotoxic symptoms. The causes of thyrotoxicosis were Grave's disease (75%) and painless thyroiditis (25%). On coronary angiography, severe coronary spasm was observed by provocation in 6 patients, and total occlusion of right coronary artery and left circumflex artery with chest pain developed in 2 of 6 patients. After antithyroid treatment, all patients became free of chest pain. CONCLUSION: Severe coronary artery spasm can be associated with thyrotoxicosis. Thyroid function test might be a differential diagnostic test in patients with coronary artery spasm. It should be considered that thyrotoxicosis can be presented by coronary artery spasm without typical symptom of thyrotoxicosis.
