| Abstrakt: |
Thyrotoxic cardiomyopathy is characterized by persistent arrhythmias, decreased cardiopulmonary functional capacity during exercise, shortness of breath and other manifestations of heart failure, cardiac dilatation, third heart sound, pulmonary hypertension and dilated cardiomyopathy. Cases of thyrotoxicosis have been reported with clinical and electrocardiographic (ECG) data for acute myocardial infarction, resembling Takot-subo syndrome (stress cardiomyopathy) in the absence of occlusion or spasm of the coronary arteries. The case described here concerns a 28-year-old man hospitalized for acute coronary syndrome with anginal status and ST-elevations in low-lateral leads II, III, AVF, V5-V6. From urgently performed selective coronary angiography (SCAG) and left ventriculography (LVG), smooth epicardial coronary arteries without stenotic lesions were found in the presence of segmental kinetic disorders of the type of stress-induced cardiomyopathy. Additionally, the studies revealed destructive thyrotoxicosis and the presence of cytomegalovirus (CMV) antibodies IgG. The patient was diagnosed to have CMV-induced destructive thyrotoxicosis, causing thyrotoxic cardiomyopathy or CMV myocarditis and concomitant destructive thyroiditis. After initiation of symptomatic treatment and glucocorticoids, the patient reported subjective improvement. Moreover, normalization of thyroid hormones, complete recovery of global LV function and also normalization of electrocardiographic changes were found. [ABSTRACT FROM AUTHOR] |
