Hyperthyroid Crisis

Prevention and management of hyperthyroid storm

“…Thyroid hormone has a direct effect on the heart [24,25]. In longstanding thyrotoxicosis, which is most likely to terminate in storm [i5], cardiac changes are often evident [26,27]. In an old but very thorough study of the heart in 178 fatal cases of thyrotoxicosis, Kepler and Barnes [27] found that 27 patients had severe congestive heart failure and a significant number of these had no demonstrable organic heart disease.…”

“…the increased peripheral deiodination of T4 to produce T3, or the release of T3 from its protein binding, might both be contributing factors in storm. The suggestion of Graham [26] that salicylates should not be used in severe thyrotoxicosis appears to be theoretically sound.…”