Subclinical Hypothyroidism or Thyroid Autoimmunity and Variant Angina: By Chance? or with a Chance?

Proper functioning of thyroid is of importance due to its effects on the cardiovascular system. Furthermore, the relationship between hyperthyroidism and coronary vasospasm is well-known and has been continuously reported since the first description in a case report in 1979. The most important treatment of thyroid disease is the control of thyrotoxicosis and the majority of cases showed excellent outcomes after treatment of thyroid problems. While the relationship with hypothyroidism, including subclinical hypothyroidism, and coronary vasospasm has not been well-established until date, Nishikawa et al. reported their experience with variant angina in a patient of isolated adrenocorticotropin deficiency, inappropriate vasopressin secretion, and Hashimoto’s thyroiditis. However, the patient had additional endocrine problems and the authors concluded that this variant angina was more related with the isolated adrenocorticotropin deficiency rather than Hashimoto’s thyroiditis. In 1979, an earlier report demonstrated a case of variant angina that was well controlled with nitrate administration, and aggravated with the development of hypothyroidism and concurrent use of propranolol. Authors extrapolated aggravation of variant angina by working on beta blockers, which mediated alpha-mediated coroEditorial