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Takotsubo cardiomyopathy with left ventricle thrombus caused by subacute thyroiditis
  1. Daichi Yamazaki,
  2. Yoshinori Osaki,
  3. Hiroaki Suzuki and
  4. Hitoshi Shimano
  1. Internal Medicine (Endocrinology and Metabolism), University of Tsukuba, Tsukuba, Japan
  1. Correspondence to Dr Daichi Yamazaki; d.yamazaki93{at}gmail.com

Abstract

We report a rare case of takotsubo cardiomyopathy caused by subacute thyroiditis in a man in his 50s. He went to the doctor with complaints of loss of appetite, diarrhoea, chills and general malaise. He had consciousness disturbance, thyrotoxicosis and thyroid-stimulating hormone (TSH) suppression. Thyroglobulin and C reactive protein levels in the blood were elevated, but TSH receptor antibody, thyroid-stimulating antibody, antithyroglobulin antibody and antithyroid peroxidase antibody were not. We began treatment with prednisolone and propranolol after he was diagnosed with thyroid storm caused by subacute thyroiditis. The ECG revealed inverted T waves on the fifth day after admission. He was newly diagnosed with takotsubo cardiomyopathy on the day. A large thrombus was detected in the left ventricle, requiring anticoagulation therapy. Thus, even if there are no findings of takotsubo cardiomyopathy or thrombus at the onset of thyroid storm, appropriate monitoring is required because they can develop during the treatment course.

  • Thyroid disease
  • Cardiovascular medicine
  • Thyroiditis

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Footnotes

  • Contributors DY wrote the case report and performed the literature search for writing the Discussion section. YO is the primary endocrinologist of this patient, reviewed the case report, provided suggestions for further improvement and authorised the final version of the case report. HSu and HSh reviewed the case report and provided suggestions for further improvement.

  • 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.