IODINATED CONTRAST MEDIA INDUCED THYROID STORM AND ACUTE CORONARY SYNDROME: A CASE REPORT

Area of Science:

• Endocrinology
• Cardiology
• Radiology

Background:

• Thyroid storm is a severe, life-threatening thyrotoxicosis complication with high mortality.
• Iodinated contrast media (ICM) administration delivers a massive iodide load, disrupting thyroid hormone regulation.
• High iodide loads can induce hypothyroidism (Wolff-Chaikoff) or hyperthyroidism (Jod-Basedow), especially in nodular thyroid disease.

Observation:

• A 37-year-old man with acute myocardial infarction underwent primary PCI using ICM.
• Post-procedure, thyrotoxicosis was detected, treated, and the patient discharged.
• One week later, the patient presented with symptoms of thyroid storm.

Findings:

• Coronary angiography with ICM can precipitate thyroid storm in patients with underlying thyroid conditions.
• Thyrotoxicosis may manifest after ICM exposure, even without prior symptoms.
• Prompt recognition and management of ICM-induced thyrotoxicosis are critical.

Implications:

• Highlights the risk of ICM in precipitating thyroid storm.
• Emphasizes the need for routine thyroid function screening post-ICM in at-risk patients.
• Suggests enhanced vigilance for thyroid dysfunction following cardiac interventions involving ICM.