Abstract
A 40-year-old African-American woman presented with atypical chest pain, an acute non-ST segment elevation myocardial infarction, and angiographic evidence for severe ostial vasospasm of the left main and right coronary arteries. Subsequently, she was diagnosed with hyperthyroidism and treated with antithyroid therapy and oral nitrates. Repeat angiography revealed resolution of the vasospasm; however, the chest pain recurred in the euthyroid state. Hyperthyroidism-associated coronary vasospasm is a rare disorder that characteristically causes angina in young Asian women and resolves with correction of hyperthyroidism. We present an atypical case of an African-American woman presenting with a myocardial infarction who developed recurrent angina while euthyroid.
MeSH terms
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Adrenergic beta-Antagonists / pharmacology
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Adult
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Angina Pectoris / diagnostic imaging
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Angina Pectoris / drug therapy
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Angina Pectoris / etiology*
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Antithyroid Agents / therapeutic use
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Coronary Angiography
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Coronary Vasospasm / complications*
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Coronary Vasospasm / diagnostic imaging
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Coronary Vasospasm / drug therapy
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Coronary Vasospasm / etiology
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Euthyroid Sick Syndromes / diagnostic imaging
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Euthyroid Sick Syndromes / drug therapy
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Euthyroid Sick Syndromes / etiology*
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Female
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Humans
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Hyperthyroidism / complications*
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Hyperthyroidism / diagnostic imaging
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Hyperthyroidism / drug therapy
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Myocardial Infarction / diagnostic imaging
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Myocardial Infarction / drug therapy
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Myocardial Infarction / etiology*
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Recurrence
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Treatment Outcome
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Vasodilator Agents / therapeutic use
Substances
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Adrenergic beta-Antagonists
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Antithyroid Agents
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Vasodilator Agents