摘要
Background The close relationship between the thyrotoxic state and abnormalities in cardiac function, arrhythmias and congestive heart failure is well known to clinicians. Patients with hyperthyroidism-induced acute myocardial infarction （AMI） are unusual and almost all reported cases have been associated with coronary vasospasm. There is quite consistent evidence that hyperthyroidism is directly associated with the presence of a prothrombotic state. Methods The present article reports a 69-year-old female with hyperthyroidism who developed myocardial infarction （MI） and reviews AMI in hyperthyroidism cases reported in the literature. We conducted a comprehensive review of the English literature since 1990 to analyze data on MI in hyperthyroidism patients who had developed AMI. Results From 11 English articles, we identified 12 hyperthyroidism patients, plus our cases, with AMI. They consisted of 11 females and 2 males. Their mean age was 49 ± 14.4 years （range 28-71）. Coronary angiography revealed normal coronary arteries in 6 patients, coronary spasm in 6 patients. Only our patient received percutaneous coronary intervention through coronary thrombus suction and other patients were treated mainly with medicine. Twelve patients had good prognosis and 1 patient died of cardiogenic shock. Conclusions Hyperthyroidism-induced AMI is rare. Coronary thrombus or spasm without coronary atherosclerotic stenosis should be considered. Different therapies should be chosen according to different types of coronary involvement.
Background The close relationship between the thyrotoxic state and abnormalities in cardiac function, arrhythmias and congestive heart failure is well known to clinicians. Patients with hyperthyroidism-induced acute myocardial infarction （AMI） are unusual and almost all reported cases have been associated with coronary vasospasm. There is quite consistent evidence that hyperthyroidism is directly associated with the presence of a prothrombotic state. Methods The present article reports a 69-year-old female with hyperthyroidism who developed myocardial infarction （MI） and reviews AMI in hyperthyroidism cases reported in the literature. We conducted a comprehensive review of the English literature since 1990 to analyze data on MI in hyperthyroidism patients who had developed AMI. Results From 11 English articles, we identified 12 hyperthyroidism patients, plus our cases, with AMI. They consisted of 11 females and 2 males. Their mean age was 49 ± 14.4 years （range 28-71）. Coronary angiography revealed normal coronary arteries in 6 patients, coronary spasm in 6 patients. Only our patient received percutaneous coronary intervention through coronary thrombus suction and other patients were treated mainly with medicine. Twelve patients had good prognosis and 1 patient died of cardiogenic shock. Conclusions Hyperthyroidism-induced AMI is rare. Coronary thrombus or spasm without coronary atherosclerotic stenosis should be considered. Different therapies should be chosen according to different types of coronary involvement.
