[Thyrotoxic crisis with cardiogenic shock]

Area of Science:

• Endocrinology
• Critical Care Medicine
• Cardiology

Background:

• Thyrotoxic crisis is a severe, life-threatening endocrine emergency.
• It necessitates prompt recognition and integrated multidisciplinary care for optimal outcomes.
• Cardiovascular complications, including cardiogenic shock and cardiac arrest, are significant risks.

Purpose of the Study:

• To present a case report of a patient with thyrotoxic crisis who developed refractory cardiogenic shock and cardiac arrest.
• To emphasize the challenges in managing severe thyrotoxic crisis, even with advanced interventions.
• To underscore the critical role of early diagnosis and coordinated interdisciplinary management.

Main Methods:

• Case report of a 59-year-old woman with thyrotoxic crisis.
• Inclusion of intensive medical therapy and emergency thyroidectomy.
• Preparation of extracorporeal membrane oxygenation as rescue support.

Main Results:

• The patient developed cardiogenic shock and cardiac arrest despite intensive therapy.
• Postoperative collapse persisted following emergency thyroidectomy.
• The patient expired shortly after the surgical intervention.

Conclusions:

• Severe thyrotoxic crisis can lead to fatal cardiovascular complications despite maximal medical and surgical interventions.
• The case highlights the critical importance of early identification and prompt, coordinated interdisciplinary care in managing thyrotoxic crisis.
• Aggressive management strategies, including surgical intervention and mechanical support, may not always prevent adverse outcomes in the most severe cases.