VASOSPASTIC ANGINA DUE TO DESTRUCTIVE THYROTOXICOSIS IN A PATIENT AFTER HEART TRANSPLANTATION: CASE-REPORT

Abstract

In current study, we described the onset of a case of vasospastic angina against the background of thyrotoxicosis.In a 48-year-old patient with transplanted heart coronary artery disease and achieved revascularization after stenting, anterior ventricular failure is used and episodes of ST elevation are preserved in the nighttime indicators of Prinzmetal’s angina in leads characterizing the potentials of the anterior septal (V1–V3), complete anterior (V4–V5), lateral (V6, I), lower diaphragmatic (III, avF) tissue of the left ventricle regardless of physical activity and despite optimal drug therapy with calcium channel blockers and nitrates. The patient did not have characteristic clinical signs of thyrotoxicosis, probably due to ongoing immunosuppressive therapy, in particular, glucocorticosteroids.Destructive thyrotoxicosis was diagnosed due to high T4\T3 ratio, absence of TSH receptor antibodies, and a diffuse decrease of 99mTc-pertechnetate uptake. After increasing the dose of glucocorticosteroids and achieving euthyroid state, the episodes of ST elevation resolved.This case emphasizes the importance of timely detection and proper differential diagnosis of thyrotoxicosis. The clinical course of thyrotoxicosis in patients with severe cardiovascular pathology is often atypical and complicated. Restoration of normal thyroid function may lead to the regression of associated cardiac arrhythmias.