Positive cardiac troponin I and T and chest pain in a patient with iatrogenic hypothyroidism and no coronary artery disease

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Item Type:	Article
Title:	Positive cardiac troponin I and T and chest pain in a patient with iatrogenic hypothyroidism and no coronary artery disease
Creators Name:	Buschmann, I.R., Bondke, A., Elgeti, T., Kuehnle, Y., Dietz, R. and Moeckel, M.
Abstract:	We report about a 41-year old male patient who presented to the emergency room with acute chest pain, exertion dyspnoea, muscle stiffness, myalgia and adynamia. There was no history of coronary artery disease but known arterial hypertension and insulin dependent diabetes mellitus. Four weeks before submission the patient had been thyroidectomized after he had been diagnosed with papillary thyroid carcinoma and was now awaiting further radioiodine therapy. The thyroid-stimulating hormone level was markedly elevated to 67 mU/l (normal range 0.27-4.20 mU/l) and fT4 significantly reduced to 0.19 ng/ml (normal range 0.9-1.9 ng/ml). CK was elevated to 328 U/l, cardiac Troponin I (Stratus(R) CS) above the threshold with 0.13 mug/l and Elecsys(R) third generation troponin T above the threshold with 0.04 mug/l. The electrocardiogram showed a normal sinus rhythm and did not reveal any signs of ST-elevation or -depression. During follow-up a cardiac MRI was performed, showing normal dimensions and function but a very small area of diffuse myocardial damage, atypical of ischemic injury. In coronary angiography normal coronary arteries were found. We conclude that cardiac troponins I and T may be elevated in severe hypothyroidism without coronary artery disease due to diffuse myocardial injury which can be imaged by MRI.
Keywords:	Troponin I, Troponin T, Hypothyroidism, MRI, Acute chest pain
Source:	International Journal of Cardiology
ISSN:	0167-5273
Publisher:	Elsevier
Volume:	115
Page Range:	e83-e85
Date:	7 February 2007
Official Publication:	https://doi.org/10.1016/j.ijcard.2006.08.016
PubMed:	View item in PubMed

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