methimazole and Chest-Pain

Hyperthyroidism is associated with a number of heart diseases, and it may aggravate previous cardiac problems or cause new ones, such as hyperthyroid cardiopathy. Cases of hyperthyroidism presenting with coronary vasospasm are rarely reported. Herein, we present a case of a 54-year male patient with recurrent left chest pain for 2 months. Coronary angiography showed no obvious coronary artery stenosis, and coronary vasospasm was suspected. After admission, the patient's thyroid function and TSH-receptor antibody (TRAb) were abnormal. However, there was no obvious palpitation, hyperhidrosis, or weight loss, and the diagnosis of Graves' disease was rendered, which seemed to be the cause of coronary vasospasm. The patient did not experience chest pain after treatment with methimazole. Patients with coronary vasospasm should be investigated for the possibility of hyperthyroidism. Key Words: Hyperthyroidism, Chest pain, Coronary angiography, Coronary vasospasm.

Topics: Antithyroid Agents; Chest Pain; Coronary Vasospasm; Graves Disease; Humans; Hyperthyroidism; Male; Methimazole

Topics: Adrenergic beta-Antagonists; Aged; Agranulocytosis; Amiodarone; Anti-Arrhythmia Agents; Antithyroid Agents; Atrial Fibrillation; Chest Pain; Cholangitis; Glucocorticoids; Humans; Hyperthyroidism; Hypothyroidism; Male; Methimazole; Plasmapheresis

Hyperthyroidism is associated with an increase in myocardial oxygen consumption that, due to an imbalance of oxygen demand and supply, can cause angina. However, subclinical hyperthyroidism rarely presents as chest pain in the resting state. Herein, we present a case of subclinical hyperthyroidism involving a 58-year-old male who complained of frequent chest tightness and typical electrocardiographic changes while in a resting state. Coronary angiography showed no significant lesion. Laboratory data showed that the patient suffered from hyperthyroidism, for which he was successfully treated with anti-thyroid agents. We are reminded that typical chest pain might be the first symptom of hyperthyroidism.

Topics: Angina, Unstable; Antithyroid Agents; Chest Pain; Coronary Angiography; Electrocardiography; Humans; Hyperthyroidism; Male; Methimazole; Middle Aged; Treatment Outcome