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Background <p>Acute myocardial infarction during pregnancy is a rare condition with an incidence of 1 to 10 per 100,000 deliveries. ST-elevation myocardial infarction (STEMI) is dominating the clinical presentation. It is estimated that 29% of the patients had normal coronary arteries, and hyperthyroidism may be associated with coronary vasospasm.</p> <p><b>Case Presentation</b>: A 30-year-old pregnant woman was referred with inferior STEMI post-failed fibrinolytic therapy. Her hospitalization course was complicated by non-sustained ventricular tachycardia and cardiogenic shock. Coronary angiography revealed normal coronary arteries without intracoronary thrombus, coronary dissection, or coronary atherosclerotic lesion. Laboratory test showed high Free T4 2.71&#xa0;ng/dL and low TSH &lt; 0.05 mlU/mL. Patient’s condition and hospitalization course were significantly improved after the initiation of hyperthyroid therapy. We suspected a hyperthyroid-induced coronary vasospasm as a potential etiology of myocardial infarction with non-obstructive coronary artery (MINOCA) in this patient.</p> Conclusion <p>Although MINOCA due to hyperthyroidism is a rare finding among pregnant young woman, recognizing this etiology is a paramount of importance due to improved survival with appropriate and specific therapy.</p>

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When the heart deceives: a case report of hyperthyroidism disguised as STEMI in female pregnant patient

  • 期刊论文

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  • 发表日期：

    2025年1月15日

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  • Kevin Wibawa,
  • Lidia Debby Wiyono,
  • Raditya Dewangga,
  • Arief Sumarna,
  • Wizhar Syamsuri,
  • Yandi Ariffudin,
  • Suhendiwijaya Suhendiwijaya,
  • Pangeran Akbar Syah

摘要

Background

Acute myocardial infarction during pregnancy is a rare condition with an incidence of 1 to 10 per 100,000 deliveries. ST-elevation myocardial infarction (STEMI) is dominating the clinical presentation. It is estimated that 29% of the patients had normal coronary arteries, and hyperthyroidism may be associated with coronary vasospasm.

Case Presentation: A 30-year-old pregnant woman was referred with inferior STEMI post-failed fibrinolytic therapy. Her hospitalization course was complicated by non-sustained ventricular tachycardia and cardiogenic shock. Coronary angiography revealed normal coronary arteries without intracoronary thrombus, coronary dissection, or coronary atherosclerotic lesion. Laboratory test showed high Free T4 2.71 ng/dL and low TSH < 0.05 mlU/mL. Patient’s condition and hospitalization course were significantly improved after the initiation of hyperthyroid therapy. We suspected a hyperthyroid-induced coronary vasospasm as a potential etiology of myocardial infarction with non-obstructive coronary artery (MINOCA) in this patient.

Conclusion

Although MINOCA due to hyperthyroidism is a rare finding among pregnant young woman, recognizing this etiology is a paramount of importance due to improved survival with appropriate and specific therapy.