Mustafa Cetìn, Ozgül Uçar, Zehra Güven Cetìn, Hülya Cìçekçìoglu
Department of Cardiology, Atatürk Chest Disease and Chest Surgery Education and Research Hospital, Sanatoryum caddesi, Turkey.
Intern Med. 2011;50(15):1595-7. doi: 10.2169/internalmedicine.50.5099. Epub 2011 Aug 1.
A 53-year-old man presented with angina pectoris and ST-segment elevation in V(1)-V(4) leads. Electrocardiogram changes and chest pain were completely resolved with nitroglycerine infusion. Coronary angiogram revealed normal epicardial vessels. These findings suggest that the acute myocardial ischemia was secondary to coronary vasospasm. From his medical history we learned that he was taking L-thyroxine and the dose had been increased two months previously. He was found to be in thyrotoxic state at admission. L-thyroxine treatment was withheld and diltiazem was given. He had no further symptoms. In conclusion we think that acute myocardial ischemia was likely secondary to L-thyroxine-induced coronary spasm.
一名53岁男性因心绞痛及V（1）-V（4）导联ST段抬高就诊。静脉输注硝酸甘油后，心电图改变及胸痛完全缓解。冠状动脉造影显示心外膜血管正常。这些发现提示急性心肌缺血继发于冠状动脉痉挛。从其病史中我们了解到他正在服用左甲状腺素，且剂量在两个月前已增加。入院时发现他处于甲状腺毒症状态。停用左甲状腺素治疗并给予地尔硫䓬。他未再出现症状。总之，我们认为急性心肌缺血可能继发于左甲状腺素诱导的冠状动脉痉挛。
