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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
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Thyrotoxicosis-Induced Cardiogenic Shock: Acute Management Using a Multidisciplinary Approach
Oluwaremilekun Z Tolu-Akinnawo1, Joseph Abiade1, Tiwalade Awosanya2
1Internal Medicine, Meharry Medical College, Nashville, USA.
Cureus
|December 26, 2022
Summary
Thyrotoxicosis can cause life-threatening heart problems. Non-cardioselective beta-blockers may worsen heart failure in these patients, necessitating a multidisciplinary approach for recovery.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Thyrotoxicosis and thyroid storm can lead to heart failure and cardiomyopathy.
- These conditions are significant causes of mortality in adults.
- Non-cardioselective beta-blockers can precipitate severe cardiac decompensation in patients with unknown cardiac dysfunction.
Observation:
- A 63-year-old male with hyperthyroidism presented with shortness of breath, hypotension, and irregular tachycardia.
- The patient rapidly decompensated after receiving IV metoprolol, requiring intubation and pressor support.
- Echocardiography revealed four-chamber dilation, reduced ejection fraction, and global hypokinesis.
Findings:
- Thyrotoxicosis-induced cardiomyopathy and cardiogenic shock were diagnosed.
- Administration of a non-cardioselective beta-blocker was identified as the cause of rapid deterioration.
- Multidisciplinary management involving Endocrinology, Cardiology, and Pulmonary Critical Care was initiated.
Implications:
- This case underscores the critical importance of assessing cardiac function before beta-blocker initiation in thyrotoxicosis.
- A multidisciplinary team approach is vital for managing thyrotoxicosis-induced cardiogenic shock.
- Prompt intervention and collaborative care led to patient recovery and discharge.
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