{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:52:11Z","timestamp":1792234331116,"version":"4.4.0"},"reference-count":23,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,1,26]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>A man in his 40s who was previously well had an out-of-hospital cardiac arrest. Postresuscitation ECG showed ST-elevation myocardial infarction (MI). Emergency coronary angiogram revealed MI with non-obstructive coronary arteries (MINOCA) with evidence of spasm in the right coronary artery. Both his echocardiogram and cardiac MRI revealed a normal heart. Further workup showed markedly elevated free T4 (99.5\u2009pmol\/L) and free T3 (26.7\u2009pmol\/L) with low thyroid stimulating hormone (&lt;0.02\u2009pmol\/L) in keeping with thyroid storm. He also had an elevated adjusted calcium level (2.84\u2009mmol\/L), which could have contributed to his coronary artery spasm. His peak troponin T was elevated at 798\u2009ng\/L (&lt;14) suggesting myocardial damage. He was treated with propylthiouracil, steroids, beta-blocker, calcium channel blocker and intravenous fluids. The patient achieved a full recovery and was discharged home. This is an unusual case of thyroid dysfunction resulting in coronary artery spasm, cardiac arrest and MINOCA.<\/jats:p>","DOI":"10.1136\/bcr-2022-253500","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T09:13:10Z","timestamp":1676020390000},"page":"e253500","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Cardiac arrest in myocardial infarction with non-obstructive coronary artery (MINOCA) secondary to thyroid dysfunction"],"prefix":"10.1136","volume":"16","author":[{"given":"Ahmed Moemen A","family":"Omar","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristopher","family":"Knott","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdi M","family":"Saba","sequence":"additional","affiliation":[{"name":"Advanced Ventricular Arrythmia Training and Research Program, Department of Cardiology, St George's Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pitt O","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,10]]},"reference":[{"key":"2025082707370232000_16.2.e253500.1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.116.003443","article-title":"Mortality of myocardial infarction by sex, age, and obstructive coronary artery disease status in the action registry-GWTG (acute coronary treatment and intervention outcomes network registry-get with the guidelines)","volume":"10","author":"Smilowitz","year":"2017","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2025082707370232000_16.2.e253500.2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.14740\/jmc3473","article-title":"Coronary vasospasm-induced myocardial infarction: an uncommon presentation of unrecognized hyperthyroidism","volume":"11","author":"Ataallah","year":"2020","journal-title":"J Med Cases"},{"key":"2025082707370232000_16.2.e253500.3","doi-asserted-by":"publisher","DOI":"10.1136\/heart.84.4.455"},{"key":"2025082707370232000_16.2.e253500.4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s10840-010-9507-3","article-title":"Ventricular fibrillation associated with early repolarization in a patient with thyroid storm","volume":"29","author":"Ueno","year":"2010","journal-title":"J Interv Card Electrophysiol"},{"key":"2025082707370232000_16.2.e253500.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(79)80023-5"},{"key":"2025082707370232000_16.2.e253500.6","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(03)13137-6","article-title":"Ventricular fibrillation in a young Asian man","volume":"361","author":"Boccalandro","year":"2003","journal-title":"Lancet"},{"key":"2025082707370232000_16.2.e253500.7","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0368"},{"key":"2025082707370232000_16.2.e253500.8","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-200406000-00020"},{"key":"2025082707370232000_16.2.e253500.9","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.ajem.2014.12.071","article-title":"Painless thyroiditis-induced acute myocardial infarction with normal coronary arteries","volume":"33","author":"Zheng","year":"2015","journal-title":"Am J Emerg Med"},{"key":"2025082707370232000_16.2.e253500.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2006.07.007"},{"key":"2025082707370232000_16.2.e253500.11","doi-asserted-by":"publisher","DOI":"10.1161\/hc4301.098254"},{"key":"2025082707370232000_16.2.e253500.12","unstructured":"Yow AG , Rajasurya V , Sharma S . 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