Out of the blue! Thyroid crisis

Area of Science:

• Cardiology
• Endocrinology
• Anesthesiology

Background:

• Cardiovascular complications in undiagnosed hyperthyroidism present diagnostic challenges.
• Thyroid storm, a severe manifestation of hyperthyroidism, requires prompt management.

Observation:

• A 45-year-old male presented with atrial fibrillation and left ventricular dysfunction prior to emergency surgery.
• Thyromegaly was noted during central venous catheterization, raising suspicion for thyroid dysfunction.

Findings:

• Echocardiography showed left ventricular dysfunction (ejection fraction 47%) without structural abnormalities.
• The patient's cardiovascular status was attributed to undiagnosed hyperthyroidism, leading to thyroid crisis.
• Successful management of the thyroid crisis was achieved.

Implications:

• Highlights the importance of considering thyroid dysfunction in patients with unexplained cardiac issues, particularly perioperatively.
• Emphasizes the need for timely diagnosis and aggressive management of thyroid storm to prevent fatal outcomes.
• Underscores the critical role of multidisciplinary collaboration in managing complex endocrine-cardiac emergencies.