{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:16:48Z","timestamp":1784557008370,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,11,16]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Angina pectoris in pregnancy is unusual and Prinzmetal\u2019s angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves\u2019 disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70\u201380\u2009000\u2009IU\/L. Gestational transient thyrotoxicosis is transient and generally resolves spontaneously in the latter half of pregnancy, and specific antithyroid treatment is not required. Treatment with calcium channel blockers or nitrates reduces spasm in most of these patients. Overall, the prognosis for hyperthyroidism-associated coronary vasospasm is good. We describe a very rare case of an acute myocardial infarction in a 27-year-old female, at 9 weeks of gestation due to right coronary artery spasm secondary to gestational hyperthyroidism with free thyroxine of 7.7\u2009ng\/dL and TSH &lt;0.07\u2009IU\/L.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>AMI and cardiac arrest due to GTT despite optimal medical therapy is extremely rare.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Gestational hyperthyroidism should be considered in pregnant patients presenting with ACS-like symptoms especially in the setting of hyperemesis gravidarum.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Our case highlights the need for increased awareness of general medical community that GTT can lead to significant cardiac events. Novel methods of controlling GTT as well as medical interventions like ICD need further study.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-16-0063","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T02:27:26Z","timestamp":1479263246000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":3,"title":["A rare case of gestational thyrotoxicosis as a cause of acute myocardial infarction"],"prefix":"10.1530","volume":"2016","author":[{"given":"Varalaxmi Bhavani","family":"Nannaka","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Lvovsky","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20161117111216632_bib1","doi-asserted-by":"crossref","first-page":"751","DOI":"10.7326\/0003-4819-125-9-199611010-00009","article-title":"Acute myocardial infarction associated with pregnancy.","volume":"125","author":"Roth","year":"1996","journal-title":"Annals of Internal Medicine"},{"key":"key20161117111216632_bib2","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1161\/CIRCULATIONAHA.105.576751","article-title":"Acute myocardial infarction in pregnancy: a United States population-based study.","volume":"113","author":"James","year":"2006","journal-title":"Circulation"},{"key":"key20161117111216632_bib3","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1136\/hrt.74.6.700","article-title":"Severe coronary vasospasm associated with hyperthyroidism causing myocardial infarction","volume":"74","author":"Masani","year":"1995","journal-title":"British Heart Journal"},{"key":"key20161117111216632_bib4","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S0002-9149(79)80023-5","article-title":"Coronary spasm with ventricular fibrillation during thyrotoxicosis: response to attaining euthyroid state","volume":"43","author":"Wei","year":"1979","journal-title":"American Journal of Cardiology"},{"key":"key20161117111216632_bib5","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/BF03348950","article-title":"Serum levels of intact human chorionic gonadotropin (HCG) and its free alpha and beta subunits, in relation to maternal thyroid stimulation during normal pregnancy.","volume":"16","author":"Glinoer","year":"1993","journal-title":"Journal of Endocrinological Investigation"},{"key":"key20161117111216632_bib6","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1089\/thy.1998.8.859","article-title":"Thyroid hyperfunction during pregnancy.","volume":"8","author":"Glinoer","year":"1998","journal-title":"Thyroid"},{"key":"key20161117111216632_bib7","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.1365-2265.1993.tb00512.x","article-title":"Gestational thyrotoxicosis and hyperemesis gravidarum: possible role of hCG with higher stimulating activity.","volume":"38","author":"Kimura","year":"1993","journal-title":"Clinical Endocrinology"},{"key":"key20161117111216632_bib8","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1089\/thy.2007.0051","article-title":"Thyroid disease and vascular function.","volume":"17","author":"Owen","year":"2007","journal-title":"Thyroid"},{"key":"key20161117111216632_bib9","doi-asserted-by":"crossref","first-page":"3076","DOI":"10.1161\/hc5001.100621","article-title":"Impact of hyperthyroidism and its correction on vascular reactivity in humans.","volume":"104","author":"Napoli","year":"2001","journal-title":"Circulation"},{"key":"key20161117111216632_bib10","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/S0002-9149(02)02283-X","article-title":"Usefulness of implantable cardioverter-defibrillators in refractory variant angina pectoris complicated by ventricular fibrillation in patients with angiographically normal coronary arteries","volume":"89","author":"Meisel","year":"2002","journal-title":"American Journal of Cardiology"}],"container-title":["Endocrinology, Diabetes &amp; 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