Cardiogenic Shock as the Initial Manifestation of Thyrotoxicosis

Thyroid storm is a condition characterized by excess circulating thyroid hormones with the development of severe clinical manifestations that may progress to cardiogenic shock, multiorgan failure, and death.

A 41-year-old woman with Graves' disease and poor medical compliance presented to the emergency department with thyroid storm. After initiation of antithyroid and beta-blocker treatment, the patient developed cardiogenic shock and multiorgan failure, requiring placement of a temporary mechanical circulatory support device, immunosuppressive treatment with corticosteroids, and plasmapheresis. She had a good clinical response and underwent total thyroidectomy.

Thyroid storm is a rare cause of cardiogenic shock and multiorgan failure with a high mortality rate despite medical treatment. The case emphasizes the usefulness of multidisciplinary management to avoid adverse outcomes.

The case demonstrates the usefulness of alternative therapies (eg, plasmapheresis) and caution in the use of beta-blockers in patients with thyroid storm.