관상동맥 연축으로 진단되는 갑상선중독증 환자의 임상적 특징Clinical Characteristics of Thyrotoxicosis Presented by Coronary Spasm
- Other Titles
- Clinical Characteristics of Thyrotoxicosis Presented by Coronary Spasm
- Authors
- 김기원; 이세환; 전성완; 김여주; 김상진
- Issue Date
- 2013
- Publisher
- 대한갑상선학회
- Keywords
- 갑상선중독증; 관상동맥 연축; Thyrotoxicosis; Coronary vasospasm
- Citation
- International Journal of Thyroidology, v.6, no.1, pp.64 - 68
- Journal Title
- International Journal of Thyroidology
- Volume
- 6
- Number
- 1
- Start Page
- 64
- End Page
- 68
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/14424
- ISSN
- 2384-3799
- Abstract
- Background and Objectives: Cardiovascular symptoms are integral and often the most predominant clinical presentation in patients with thyrotoxicosis. In patients with known or suspected coronary artery disease, myocardial ischemia and angina-like chest pain may be presented due to increase in cardiac output and cardiac contractility as a result of thyrotoxicosis. In addition, coronary spasm may result in angina-like chest pain in thyrotoxicosis patients without any fixed coronary artery stenosis. However, there are few reports about clinical characteristics of thyrotoxicosis associated with coronary artery spasm. Materials and Methods: Coronary angiography, thyroid function test, and follow-up clinical data of patients were analyzed retrospectively. Results: Twelve patients with coronary artery spasm were included over 4.5 years (male:female, 5:7). The mean age of patients was 53.3 years (range, 27 to 68), and female patients were younger than male patients (mean, 56.2 vs. 51.2 years). Only 4 patients (33%) presented typical thyrotoxic symptoms. The causes of thyrotoxicosis were Grave’s disease (75%) and painless thyroiditis (25%). On coronary angiography, severe coronary spasm was observed by provocation in 6 patients, and total occlusion of right coronary artery and left circumflex artery with chest pain developed in 2 of 6 patients. After antithyroid treatment, all patients became free of chest pain. Conclusion: Severe coronary artery spasm can be associated with thyrotoxicosis. Thyroid function test might be a differential diagnostic test in patients with coronary artery spasm. It should be considered that thyrotoxicosis can be presented by coronary artery spasm without typical symptom of thyrotoxicosis.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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