Work

Darting Waves and Diagnostic Twists

Year: 2025

Type: article

Abstract: BACKGROUND: We describe a patient who was found to have a rare electrocardiogram pattern in the setting of hyperthyroidism and discuss differential diagnoses and pathophysiology. TAKE-HOME MESSAGES: The take home-messages are to recognize the importance of considering endocrine etiology in irregular electrophysiology, and to recognize mimics of structural and ischemic heart disease that can resolve with appropriate therapy. CASE SUMMARY: A 40-year-old man presented with chest pain and questionable lateral lead ST-segment elevations on electrocardiogram and T waves with bifid morphology. Blood pressure and heart rate were 129/66 mm Hg and 98 beats/min, respectively. Laboratory results revealed cardiac troponin of 5 ng/mL, magnesium of 1.6 mg/dL, potassium of 4.3 mmol/L, unremarkable renal function, thyroid stimulating hormone <0.010 ulU/mL, free thyroxine of 2.90 ng/dL, and free triiodothyronine of 376.1 ng/dL.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105916

Authors: Swasti Mehta, Kathleen Quealy, Mohamed Farhan Nasser

Institutions: MetroHealth Medical Center, Case Western Reserve University

Language: English

Topic: Thyroid Disorders and Treatments

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850