Coronary artery spasm in hypothyroidism

A previous report by Wei et al¹ documented coronary spasm possibly caused by hyperthyroidism. It was speculated that an increase in the number of α receptors secondary to hyperthyroidism may render the coronary arteries more vulnerable to spasm when transient increases in parasympathetic tone with attendant post-ganglionic catecholamine release occurred. The present report of coronary spasm occurring in a patient with hypothroidism is the first described association of these conditions. The demonstration that spasm may be seen with either hyper- or hypothyroidism suggests that the connection of coronary spasm with thyroid dysfunction may be more tenuous and variable than previously postulated.