Abstract
Hypothyroid patients have increased concentrations of creatinine kinase that is mostly due to increased CK-MM. However, CK-MB has also been reported to increase above reference values in hypothyroid patients without apparent myocardial damage. This may create confusion during the evaluation of myocardial injury in a hypothyroid patient presenting with chest pain. Troponin I is considered as a superior marker for the diagnosis of myocardial infarction in hypothyroid patients. However, there are some reports showing an increase in the level of troponin I without any myocardial damage in hypothyroid patients as in our case. In this report, we present a 47 years old male hypothyroid patient who had chest pain, abnormal electrocardiographic findings and increased cardiac enzymes suggesting acute coronary syndrome although he had normal coronary arteriogram.
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References
Klein I, Ojamaa K (2001) Thyroid hormone and the cardiovascular system. New Engl J Med 344:501–509
Chan KM, Ladenson JH (1986) Increased creatine kinase MB in the absence of acute myocardial infarction. Clin Chem 32:2044–51
Gammage M, Franklyn J (1997) Hypothyroidism, thyroxine treatment, and the heart. Heart 77:189–190
Toft AD, Boon NA (2000) Thyroid disease and the heart. Heart 84:455–460
Slovis C, Jenkins R (2002) ABC of clinical electrocardiography: Conditions not primarily affecting the heart. BMJ 324:1320–3
Kahaly GJ, Dillmann WH (2005) Thyroı ıd hormone actı ıon in the heart. Endocr Rev 4L1–70
Cohen LF, Mohabeer AJ, Keffer JH, Jialal I (1996) Troponin I in hypothyroidism. Clin Chem 42:1494–5
Strachan SR, Afolabi O, Brown N, Gray D (2000) Chest pain, enzymes and hypothyroidism. Postgrad Med J 76:168–9
Khan IA, Tun A, Wattanasauwan N, Win MT, Hla TA, Hussain A, Vasavada BC, Sacchi TJ (1999) Elevation of serum cardiac troponin I in noncardiac and cardiac diseases other than acute coronary syndromes. Am J Emerg Med 17:225–9
Grewal J, Gin K (2004) Troponin Marks the spot!. Perspectives in Cardiology 20:35–40
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Address for correspondence: Huseyin Gunduz, MD, Department of Internal Medicine and Cardiology, Izzet Baysal Medical Faculty, Izzet Baysal University, Bolu, 14100 Turkey Tel.: +90-374-217-65-20 E-mail: drhuseyingunduz@yahoo.com
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Gunduz, H., Arinc, H., Yolcu, M. et al. A case of hypothyroidism mimicking acute coronary syndrome. Int J Cardiovasc Imaging 22, 141–145 (2006). https://doi.org/10.1007/s10554-005-9011-5
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DOI: https://doi.org/10.1007/s10554-005-9011-5