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A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction

SUMMARY Cardiovascular disease represents the largest cause of death globally, with multifactorial causes. This is a case study of a thyroid storm with hyperactive coronary arteries resulting in acute myocardial infarction (AMI). A 56-year-old gentleman presented with left-sided chest pain radia...

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Main Authors: Ho Yik, Hon, Caryn Tsujean, Lim, Chow Han, Bing, Chan Pei, Lin, Tan Chen, Ting, Asri, Said
Format: Article
Language:English
Published: Medical Journal of Malaysia Case Reports (MJM Case Reports) 2022
Subjects:
R Medicine (General)
Online Access:http://ir.unimas.my/id/eprint/40933/1/A%20stormy%20chase%20-%20Copy.pdf
http://ir.unimas.my/id/eprint/40933/
http://mjmcasereports.org/
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spelling my.unimas.ir.409332022-12-19T07:48:51Z http://ir.unimas.my/id/eprint/40933/ A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction Ho Yik, Hon Caryn Tsujean, Lim Chow Han, Bing Chan Pei, Lin Tan Chen, Ting Asri, Said R Medicine (General) SUMMARY Cardiovascular disease represents the largest cause of death globally, with multifactorial causes. This is a case study of a thyroid storm with hyperactive coronary arteries resulting in acute myocardial infarction (AMI). A 56-year-old gentleman presented with left-sided chest pain radiating to the neck. Initial ECG showed ST elevation over anterior leads, which dynamically changed to Lambda-wave (“shark fin” pattern) over inferior leads 60 minutes later, along with raised cardiac enzymes. Urgent invasive coronary angiogram was performed, in which we repeatedly did ballooning of the left anterior descending coronary artery due to recurrent spasms in the artery, with the patient’s haemodynamics being labile with systolic blood pressure of as low as 60 mmHg. He was intubated for acute pulmonary oedema and admitted to cardiac intensive care unit postprocedure and had persistent tachycardia with multiple episodes of tachyarrhythmia. Laboratory test revealed hyperthyroidism, and he was treated for thyroid storm with Burch-Wartofsky Point Scale of 50 points. However, his clinical condition deteriorated rapidly with the development of acute kidney injury and severe metabolic acidosis. He eventually succumbed after 4 days of intensive care despite maximum multidisciplinary resuscitation effort. This study calls for routine screening of thyroid function test in patients with persistent tachycardia during AMI. Medical Journal of Malaysia Case Reports (MJM Case Reports) 2022 Article PeerReviewed text en http://ir.unimas.my/id/eprint/40933/1/A%20stormy%20chase%20-%20Copy.pdf Ho Yik, Hon and Caryn Tsujean, Lim and Chow Han, Bing and Chan Pei, Lin and Tan Chen, Ting and Asri, Said (2022) A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction. MJM Case Reports Journal, 1 (2). pp. 152-155. ISSN 2948-3859 http://mjmcasereports.org/
institution Universiti Malaysia Sarawak
building Centre for Academic Information Services (CAIS)
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sarawak
content_source UNIMAS Institutional Repository
url_provider http://ir.unimas.my/
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Ho Yik, Hon
Caryn Tsujean, Lim
Chow Han, Bing
Chan Pei, Lin
Tan Chen, Ting
Asri, Said
A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction
description SUMMARY Cardiovascular disease represents the largest cause of death globally, with multifactorial causes. This is a case study of a thyroid storm with hyperactive coronary arteries resulting in acute myocardial infarction (AMI). A 56-year-old gentleman presented with left-sided chest pain radiating to the neck. Initial ECG showed ST elevation over anterior leads, which dynamically changed to Lambda-wave (“shark fin” pattern) over inferior leads 60 minutes later, along with raised cardiac enzymes. Urgent invasive coronary angiogram was performed, in which we repeatedly did ballooning of the left anterior descending coronary artery due to recurrent spasms in the artery, with the patient’s haemodynamics being labile with systolic blood pressure of as low as 60 mmHg. He was intubated for acute pulmonary oedema and admitted to cardiac intensive care unit postprocedure and had persistent tachycardia with multiple episodes of tachyarrhythmia. Laboratory test revealed hyperthyroidism, and he was treated for thyroid storm with Burch-Wartofsky Point Scale of 50 points. However, his clinical condition deteriorated rapidly with the development of acute kidney injury and severe metabolic acidosis. He eventually succumbed after 4 days of intensive care despite maximum multidisciplinary resuscitation effort. This study calls for routine screening of thyroid function test in patients with persistent tachycardia during AMI.
format Article
author Ho Yik, Hon
Caryn Tsujean, Lim
Chow Han, Bing
Chan Pei, Lin
Tan Chen, Ting
Asri, Said
author_facet Ho Yik, Hon
Caryn Tsujean, Lim
Chow Han, Bing
Chan Pei, Lin
Tan Chen, Ting
Asri, Said
author_sort Ho Yik, Hon
title A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction
title_short A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction
title_full A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction
title_fullStr A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction
title_full_unstemmed A stormy chase of coronary artery spasm : Thyroid storm in acute myocardial infarction
title_sort stormy chase of coronary artery spasm : thyroid storm in acute myocardial infarction
publisher Medical Journal of Malaysia Case Reports (MJM Case Reports)
publishDate 2022
url http://ir.unimas.my/id/eprint/40933/1/A%20stormy%20chase%20-%20Copy.pdf
http://ir.unimas.my/id/eprint/40933/
http://mjmcasereports.org/
_version_ 1753792659397279744
score 13.211869

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