We encountered 2 patients with thyrotoxicosis accompanied at its onset by progressive angina. The ST segment was elevated in one patient and depressed in the other patient during the spontaneous attacks. Coronary arteriographic findings were normal during control, and spasm was induced by ergonovine. No patients had chest pain even without antianginal medication after successful treatment of thyrotoxicosis. The coronary artery may become sensitive to spasm during thyroid hormone excess even in cases without significant coronary artery disease and previous chest pain.
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References
1.
Sandler G., Wilson GM: The nature and prognosis of heart disease in thyrotoxicosis. Q J Med28:347-369, 1958.
2.
Muggia AL, Stjernholm M., Houle T.: Complete heart block with thyrotoxic myocarditis. N Engl J Med283:1099-1100, 1970.
3.
Somerville W. , Levine SA: Angina and thyrotoxicosis. Br Heart J12:245-257, 1950.
4.
Kotler MN, Michaelides M., Bouchard RJ, et al: Myocardial infarction associated with thyrotoxicosis. Arch Intern Med132:723-728, 1973.
5.
Resnekov L., Falicov RE: Thyrotoxicosis and lactate-producing angina pectoris with normal coronary arteries. Br Heart J39:1051-1057, 1977 .
6.
Wei JY, Genecin A., Greene HL, et al: Coronary spasm with ventricular fibrillation during thyrotoxicosis: Response to attaining euthyroid state. Am J Cardiol43:335-339, 1979.
7.
Hoshino T., Aya S., Yamazaki H., et al: Akuter Myokardinfarkt bei einem jungeren Patienten mit Hypertyreose . Z Kardiol67:99-103, 1978.
8.
Gordon JA, Lenkei SC: Thyrotoxicosis associated with myocardial infarction. Can Med Assoc J90:1128-1129, 1964.
9.
Burstein J., Lamberg BA, Erama E.: Myocardial infarction in thyrotoxicosis. Acta Med Scand166:379-393, 1960.
10.
Featherstone HJ, Stewart DK: Angina in thyrotoxicosis: Thyroid related coronary artery spasm. Arch Intern Med143:554-555, 1983.
11.
Yasue H., Toyama M., Kato H., et al: Prinzmetal's angina as a manifestation of alpha-adrenergic receptor-mediated coronary artery spasm: documented by coronary arteriography. Am Heart J91:148-155, 1976.
12.
Yasue H., Tanyama M., Shimamoto M., et al: Role of autonomic nervous system in the pathogenesis of Prinzmetal's variant form of angina. Circulation50:534-539, 1974.
13.
Williams RS , Lefkowitz RJ: Thyroid hormone regulation of alpha-adrenergic receptors: Studies in rat myocardium. J Cardiovasc Pharmacol1:181-189, 1979.
14.
White CW, Zimmerman TJ: Reduced cholinergic sinus mode restraint in hyperthyroidism. Circulation54:890-895, 1976.
15.
Hoult Lrs, Moore PK: Thyroxine-induced hyperthyroid state in rats suppresses renal prostaglandin metabolism. Abstracted in Br J Pharmacol62:416p, 1978.
16.
Boden WE, Bough EW, Korr KS, et al: Exercise-induced coronary spasm with ST segment depression and normal coronary arteriography. Am J Cardiol48:193-197, 1981.
17.
Yasue H., Omoto S., Takizawa A., et al: Alkalosis-induced coronary vasoconstriction: Effects of calcium, diltiazem, nitroglycerin, and propranolol. Am Heart J102:206-209, 1981.
