Cardiac arrest in myocardial infarction with non-obstructive coronary artery (MINOCA) secondary to thyroid dysfunction.

Autor:	Omar AMA; Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK ahmedmoemenalaa@gmail.com., Knott K; Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK., Saba MM; Advanced Ventricular Arrythmia Training and Research Program, Department of Cardiology, St George's Hospital, London, UK., Lim PO; Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2023 Feb 10; Vol. 16 (2). Date of Electronic Publication: 2023 Feb 10.
DOI:	10.1136/bcr-2022-253500
Abstrakt:	A man in his 40s who was previously well had an out-of-hospital cardiac arrest. Postresuscitation ECG showed ST-elevation myocardial infarction (MI). Emergency coronary angiogram revealed MI with non-obstructive coronary arteries (MINOCA) with evidence of spasm in the right coronary artery. Both his echocardiogram and cardiac MRI revealed a normal heart. Further workup showed markedly elevated free T4 (99.5 pmol/L) and free T3 (26.7 pmol/L) with low thyroid stimulating hormone (<0.02 pmol/L) in keeping with thyroid storm. He also had an elevated adjusted calcium level (2.84 mmol/L), which could have contributed to his coronary artery spasm. His peak troponin T was elevated at 798 ng/L (<14) suggesting myocardial damage. He was treated with propylthiouracil, steroids, beta-blocker, calcium channel blocker and intravenous fluids. The patient achieved a full recovery and was discharged home. This is an unusual case of thyroid dysfunction resulting in coronary artery spasm, cardiac arrest and MINOCA. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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