Complete blood count (CBC) showed mild anemia (Hb 9.7 g/dL), and results of endocrinological tests revealed apparent hyperthyroidism and extraordinarily high BNP level (Table 1). Electrocardiogram (ECG) revealed tachycardia and ST depression in leads V4-6, with high voltage in leads V5-6 (Figure 1). Here, NPPB is linked to hyperthyroidism.