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Thyrotoxic periodic paralysis with ventricular fibrillation

Archives of Internal Medicine

|July 1, 1982

Summary

Ventricular fibrillation, a rare cardiac event, occurred in a patient with thyrotoxic hypokalemic periodic paralysis. Thyroid suppression resolved the condition, highlighting a critical link between thyroid disorders and cardiac arrhythmias.

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Area of Science:

Cardiology
Endocrinology
Genetics

Background:

Periodic paralysis encompasses a group of rare genetic disorders characterized by intermittent episodes of muscle weakness.
Hypokalemic periodic paralysis (HPP) is often associated with electrocardiographic (ECG) changes, including conduction disturbances.
While premature ventricular contractions can occur, life-threatening ventricular arrhythmias like ventricular fibrillation are exceptionally rare in HPP.

Observation:

A 40-year-old male patient of Puerto Rican descent presented with ventricular fibrillation.
The patient was diagnosed with thyrotoxic HPP, a condition linked to an overactive thyroid gland causing low potassium levels.
This marks the first reported instance of ventricular fibrillation in the context of thyrotoxic periodic paralysis.

Findings:

The patient was successfully resuscitated from ventricular fibrillation.
Following treatment with thyroid suppression, the patient became asymptomatic.
Subsequent cardiac evaluations, including ambulatory ECG monitoring, maximal exercise stress testing, and echocardiograms, revealed normal results.

Implications:

This case underscores the potential for severe cardiac complications, such as ventricular fibrillation, in thyrotoxic HPP.
It highlights the importance of considering and managing thyroid dysfunction in patients with periodic paralysis and cardiac abnormalities.
Effective thyroid suppression can prevent recurrence of both paralytic and potentially life-threatening cardiac events.

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