SHM Converge Scientific Abstract ePoster Gallery-New Onset Graves Disease Presenting as Thyro-Pericarditis

Pdf Summary

This case report describes a 27-year-old man who presented with acute pleuritic chest pain, shortness of breath, tachycardia, subjective fever, and myalgias. His workup showed markedly elevated troponin, diffuse ST elevations and PR depression on EKG, and cardiac MRI evidence of diffuse pericardial enhancement, consistent with pericarditis/myopericarditis. An ischemic cause was ruled out by left heart catheterization, which showed no coronary artery disease.<br /><br />At the same time, thyroid testing revealed suppressed TSH with elevated T3 and free T4, and thyroid ultrasound showed diffuse hyperemia, supporting a new diagnosis of Graves’ disease. The patient also had a family history of Graves’ disease and no recent medication changes, vaccinations, or travel.<br /><br />He was treated with colchicine and ibuprofen for pericarditis, along with methimazole and metoprolol for hyperthyroidism, and his chest pain and tachycardia resolved.<br /><br />The report highlights the rare simultaneous presentation of Graves’ disease and pericarditis, sometimes referred to as “thyro-pericarditis.” The authors discuss whether the two conditions share a common autoimmune mechanism or whether a viral illness may have triggered both. Because the patient had fever and myalgias before presentation, a viral trigger is considered possible, though a direct causal relationship remains unclear.

Asset Subtitle

Ji-Cheng Hsieh

Meta Tag

Author List Alex Convissar, Ji-Cheng Hsieh, Justin Q. Wang, Richard Adamovich-Zeitlin, Spencer F. Weintraub

Category Clinical Vignettes

Concept Pericarditis

Concept Graves Disease

Concept Myopericarditis

Concept Thyroid-Stimulating Hormone

Concept Thyro-Pericarditis

Distinguished Non-Finalist

Presenter Organization Zucker School of Medicine at Hofstra University

Presenting Author Ji-Cheng Hsieh

Track Adult

Keywords

Graves disease

pericarditis

myopericarditis

chest pain

troponin elevation

diffuse ST elevation

PR depression

thyro-pericarditis

hyperthyroidism

cardiac MRI

Pericarditis

Graves Disease

Myopericarditis

Thyroid-Stimulating Hormone

Thyro-Pericarditis