Thyroid storm and arrhythmic storm: a potentially fatal combination

Anjo, Diana; Maia, J. Costa; Carvalho, André; Castro, Heloísa Amélia de Lima; Aragão, Irene; Vieira, António; Reis, António Hipólito; Borges, Fátima; Torres, Severo

doi:10.1016/j.ajem.2013.04.026

Cited by 13 publications

(7 citation statements)

References 17 publications

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“…to 2%, while the mortality rate from thyroid storm is between 20% and 30%. 1 Malignant ventricular arrhythmias are much more unusual but fatal. 2 Our patient did not have ischemic cardiomyopathy, prolonged QT interval, or hypokalaemia.…”

Section: Discussionmentioning

confidence: 99%

“…One is that a large amount of thyroid hormone is secreted when the thyroid storm comes on, and an important effect on the electrophysiological properties of myocardial cells is that Na+/K+/ATP enzyme activity increased, Ca2+/ATP enzyme activity increased in the sarcoplasmic reticulum, slow cardiac calcium channel activation promoted calcium influx to enhance myocardial contractility, oxygen consumption increased, and conduction system ischemia and hypoxia grew, leading to severe arrhythmia, endangering the patients' lives. 1,8,9 The second mechanism considers that Graves disease is a systemic autoimmune disease that involves the cardiovascular system and may involve autoimmune myocarditis in the heart. Autoimmunity may alter the myocardial electrical properties promoting idiopathic ventricular arrhythmia.…”

Section: Dovepressmentioning

confidence: 99%

“…11 Lymphocytic myocarditis was found on dissection, and autoimmune myocarditis may be involved in the occurrence of malignant arrhythmias in patients with hyperthyroidism. 1,12 It should also be noted that the infection is associated with inflammation and could contribute to occurrence of Ventricular fibrillation in individuals with thyroid dysfunction.…”

Section: Dovepressmentioning

confidence: 99%

“…Thyroid storm is characterized by multiple-system involvement and complex illness, and the mortality rate is 8-30%. 1 Multiple-organ failure, congestive heart failure and respiratory failure are the main causes of death; however, malignant ventricular arrhythmias, which are potentially fatal, are much more unusual in thyroid storms. They are more common in patients with hypokalaemia, prolonged QT interval, or myocardial ischemia.…”

Section: Introductionmentioning

confidence: 99%

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<p>Malignant Arrhythmias as the Unmasked Manifestation of Thyroid Storm</p>

Shang

2020

IJGM

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Thyroid storm is usually due to a severe exacerbation of a preexisting thyrotoxicosis, which later leads to decompensation in different organ systems. Thyroid storm with malignant arrhythmia is rare, but the mortality rate is high. Malignant arrhythmia has usually occurred in some patients with hypokalemia or ischemic heart disease. The presentation of these arrhythmias in the initial phase of the disease is much less common, and only a few isolated cases are described in the scientific literature. This paper analyzes and summarizes the clinical characteristics of this disease through literature reviews, for clinicians early detection and diagnosis of this disease. We report a 51-year-old woman with diarrhoea, fever, thyroid storm, ventricular fibrillation and no potential heart disease. The case report is discussed using relevant data from literature. A total of 9 patients were reported in the literature, totalling 10 cases with ours, including 7 cases of ventricular fibrillation and 3 cases of ventricular tachycardia. Most of the treatments were antithyroid drugs, hormones and beta-receptor blockers, and 3 death cases. Patients with thyroid crisis need to be closely monitored for malignant arrhythmias. Early diagnosis and treatment may save lives.

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Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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<p>Malignant Arrhythmias as the Unmasked Manifestation of Thyroid Storm</p>

Shang

2020

IJGM

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“…[ 3 ] Among the signs and symptoms of HHD, AF is the primary manifestation and has high risks of thromboembolism and heart failure, which greatly affect patients’ quality of life and safety. [ 4 ] Importantly, it is the leading cause of death in hyperthyroidism. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%