Myocardial Infarction and Cardiac Arrest in a Patient With Severe Undiagnosed Hypothyroidism During Bronchoscopy

Awari, Daniel Wasim; Dhanasekaran, Maheswaran; Mudrakola, Harsha V.; Morales, Diana J. Valencia; Weingarten, Toby N.; Šprung, Juraj

doi:10.1053/j.jvca.2021.02.025

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Although uncommon, cardiac arrest primarily related to hypothyroidism has been reported in adults with myxedema coma due to undiagnosed hypothyroidism [11][12][13][14]. Intraoperative cardiac arrest potentially due to severe undiagnosed hypothyroidism was reported during a bronchoscopy in a 68-year-old man with multiple comorbid conditions including atrial fibrillation treated with amiodarone that resulted in hypothyroidism [15]. However, after further investigation, the primary etiology of the cardiac arrest was determined to be a myocardial infarction and not hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent

Kerbage,

Dairo,

Ketchum

et al. 2023

Cardiol Res

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Commonly identified risk factors for perioperative cardiac arrest in pediatric-aged patients include cardiac surgery, younger age, comorbid conditions including pulmonary hypertension and cyanotic congenital heart disease, and emergency surgery. Although medication-related etiologies formerly predominated, the elimination of halothane from anesthetic care has resulted in a shift in etiology to hemodynamic events related to blood loss or hyperkalemia associated with the rapid administration of blood products. Rarely, cardiac arrest can be sudden and unexpected without an identified pre-existing etiology in an otherwise apparently healthy patient. We present an 18-year-old adolescent who experienced pulseless electrical activity (PEA) and cardiac arrest following anesthetic care for an outpatient orthopedic procedure, who was eventually diagnosed with hypothyroidism. The potential etiologies of PEA and cardiac arrest during anesthesia are reviewed, components of successful resuscitation discussed, and an outline for the investigative workup presented.

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Section: Discussionmentioning

confidence: 99%

Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent

Kerbage,

Dairo,

Ketchum

et al. 2023

Cardiol Res

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“…11 There are even case reports of cardiac arrest upon induction of anesthesia in severe uncontrolled hypothyroidism. 18 It is thus critical to evaluate preoperatively in the appropriate clinical scenario (as outlined previously) and if present, severe hypothyroidism should be corrected prior to surgery.…”

Section: Hypothyroidismmentioning

confidence: 99%

Management of Atypical Slipped Capital Femoral Epiphysis

Lindgren¹,

Lieber²,

Shah³

et al. 2023

Journal of the Pediatric Orthopaedic Society of North America

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Atypical slipped capital femoral epiphyseal (SCFE) is associated with endocrine or metabolic disorders and radiation therapy. In this review, we discuss the clinical presentation for endocrinopathies, such as hyperparathyroidism, hypothyroidism, and growth hormone deficiency as well as renal osteodystrophy, radiation-induced, and valgus SCFE, with pertinent case examples. Routine laboratory screening of all patients with SCFE is likely not cost-effective. Patients with atypical SCFE are often short in stature, underweight, and present either older or younger than the typical age range (10-16 years old) of idiopathic SCFE. Patient’s fitting these criteria should undergo an endocrine workup. While uncommon, prompt recognition of atypical SCFE is crucial as coordinated care with pediatric subspecialists is necessary. In situ fixation with cannulated screws is the most common fixation method and bilateral fixation is recommended.

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Amiodarone/propofol

2021

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Myocardial Infarction and Cardiac Arrest in a Patient With Severe Undiagnosed Hypothyroidism During Bronchoscopy

Cited by 3 publications

References 21 publications

Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent

Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent

Management of Atypical Slipped Capital Femoral Epiphysis

Amiodarone/propofol

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