Acute myocardial infarction without obstructive coronary disease secondary to toxic multinodular goiter thyrotoxicosis

• Autores: Mejía Sandoval, Harvey Julián, Palmezano Díaz, Jorge Mario
• Formato: artículo
• Fecha de Publicación: 2021
• Institución: Instituto Nacional Cardiovascular
• Repositorio: Archivos peruanos de cardiología y cirugía cardiovascular
• Lenguaje: español
• OAI Identifier: oai:ojs.apcyccv.org.pe:article/90
• Enlace del recurso: https://apcyccv.org.pe/index.php/apccc/article/view/90
• Nivel de acceso: acceso abierto
• Materia: Dolor torácico; Infarto de miocardio; Tirotoxicosis; Isquemia miocárdica; Chest pain; Myocardial infarction; Thyrotoxicosis; Myocardial ischemia

Acute myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) represents a diagnostic challenge in clinical practice. Documentation of an ischemic substrate is necessary for its diagnostic approach, with a treatment that must be specific according to the identified etiology. A group of these patients presents ischemia secondary to an alteration in the oxygen supply/demand ratio. We present the case of a female adult patient, with severe hyperthyroidism and thyrotoxicosis, who develops an acute coronary syndrome, with elevated troponin T and normal coronary arteries on coronariography. Treatment was aimed at treating the triggering cause, initially pharmacologically and later surgically, with a total resolution of the condition, symptomatic improvement in the patient, and a decrease in cardiac biomarkers.