Velkoska Nakova, Valentina and Kamceva, Gordana and Jordanova, Slavica and Stojmenov, Aleksandar and Dimitrovski, Aleksandar and Ushinova, Vesna (2022) Parathyroid adenoma and angina pectoris. In: First Macedonian Congress in Internal Medicine "A Mutual Multidisciplinary Approach Towards the Gidelines Challenges", 19-22 May 2022, Hotel Metropol - Ohrid, RNM.
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Abstract
Introduction. A parathyroid adenoma (PA) is a benign tumor ; the most common reason of primary hyperparathyroidism (PHPT) is PA . Aim . To showed a male patient with PA without typical symptoms of PHPT, presented with chest pain and positive coronary stress test (CST), but normal coronary arteriography.
Case presentation.A 44 year old man with positive CST, after normal coronary arteriography was transferred to the endocrinologist because of a nodule found in the
left lobe of the thyroid gland. Nifedipine relieved the angina. On the neck ultrasound , the patient had two hypoechoic nodules (1.1 х 1.4 х 1.7 and 0.7 х 0.8x10cm) under the left lobe of the thyroid gland without symptoms of primary hyperparathyroidism (Picture 1 4). Clinical investigations showed: osteoporosis Tscore on the L1 L4 vertebrae= 3.1, and left distal radius = 4.4SD) (Picture 5 6), high total and jonizated serum calcium ( 3.0 and 1.57 mmol /L, respectivelly ) and intact PTH (320 pg /mL). Sesta mibi scaning revealed PA of the left inferior parathyroid gland (Picture 7). After conservative management, PA was surgically excided, and serum calcium and intact PTH normalized. Patohystologic result showed PA (0.6x1.2x1.6cm ) with attached parathyroid gland on the periphery of the PA.
During 2 years, follow up, postoperative controls of calcium and neck ultrasound were normal and he has had no angina.
Conclusion.Hypercalcemia due to PHPT may be reason for chest pain and ECG changes resulting with positive CST. Physicians should evaluate electrolyte and consider PHPT in patients presented with chest pain, EKG changes, positive CST but normal coronary arteriography.
| Item Type: | Conference or Workshop Item (Poster) |
|---|---|
| Subjects: | Medical and Health Sciences > Clinical medicine |
| Divisions: | Faculty of Medical Science |
| Depositing User: | Gordana Kamceva |
| Date Deposited: | 23 Jan 2024 09:46 |
| Last Modified: | 29 Jan 2024 13:57 |
| URI: | https://eprints.ugd.edu.mk/id/eprint/33256 |
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