The paradox of hypothyroidism: elevated cardiac biomarkers without coronary artery disease

Hypothyroidism should be considered in patients presenting with ischemic symptoms and elevated cardiac biomarkers, in the absence of coronary artery disease. Elevated CK-MB and troponin in hypothyroidism may result from non-cardiac mechanisms, posing significant diagnostic challenges. Thyroid function tests should be routinely included in the diagnostic evaluation of patients with atypical presentations of myocardial injury. Timely diagnosis and management of hypothyroidism can help avoid misdiagnosis and unnecessary invasive interventions.