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Case Reports: Unusual presentation of more common disease/injury
Case of coronary vasospasm caused by hypocalcaemia post parathyroidectomy mimicking ST-elevation myocardial infarction
  1. Aiswarya Ajith,
  2. Mel Corbett,
  3. Stephen Garry and
  4. Orla Young
  1. ENT department, Galway University Hospital, Galway, Ireland
  1. Correspondence to Dr Aiswarya Ajith; aiswarya.ajith{at}ucdconnect.ie

Abstract

A man in his 30s with primary hyperparathyroidism underwent an elective four-gland parathyroid exploration with intraoperative parathyroid hormone monitoring. On the fourth postoperative day (POD), the patient presented to the emergency department with severe symptomatic hypocalcaemia. ECG findings were in keeping with inferior–posterior ST-elevation myocardial infarction (STEMI); however, he was asymptomatic with no chest pain. Biochemistry revealed elevated serial troponin levels. Coronary angiogram and transthoracic echocardiogram were normal, suggesting coronary vasospasm, mimicking STEMI on ECG because of severe hypocalcaemia post parathyroidectomy. This is an uncommon and unreported complication of parathyroid surgery. The patient was successfully managed with intravenous calcium and discharged on oral calcium replacement on the tenth POD.

  • Arrhythmias
  • Ear, nose and throat
  • Thyroid disease

https://doi.org/10.1136/bcr-2021-247919

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    Footnotes

    • Contributors AA, MC, SG and OY conceptualised the structure and framework for this case study. OY was the lead consultant on the case. AA contributed towards the literature review. All authors wrote edited, supervised and contributed to revisions of the case.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.