Thromboembolic complications of thyroid storm

Area of Science:

• Endocrinology
• Cardiology
• Critical Care Medicine

Background:

• Thyroid storm is a rare, life-threatening hyperthyroidism complication.
• Atrial fibrillation occurs in up to 40% of thyroid storm patients.
• Hyperthyroidism elevates the risk of thromboembolic events.

Purpose of the Study:

• To highlight the association between thyroid storm, atrial fibrillation, and thromboembolic risk.
• To discuss the current lack of consensus on anticoagulation in severe thyrotoxicosis.
• To present a case of thyroid storm complicated by massive pulmonary embolism.

Main Methods:

• Clinical case presentation.
• Review of existing literature on hyperthyroidism, atrial fibrillation, and anticoagulation.
• Discussion of diagnostic criteria and management strategies for thyroid storm.

Main Results:

• Thyroid storm poses a significant risk for thromboembolic complications.
• Atrial fibrillation is a common comorbidity in thyroid storm.
• The case illustrates a massive pulmonary embolism as a complication.

Conclusions:

• Thyroid storm diagnosis relies on clinical findings; prompt treatment is crucial.
• A hypercoagulable state is a recognized complication of thyrotoxicosis.
• Anticoagulation should be considered for severe thyrotoxicosis with atrial fibrillation, regardless of CHADS2 score, and initiated promptly if thrombosis is evident.