Cardiogenic Shock as the Initial Manifestation of Thyrotoxicosis

心源性休克是甲状腺毒症的首发表现

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Abstract

BACKGROUND: 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. CASE SUMMARY: 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. DISCUSSION: 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. TAKE-HOME MESSAGE: The case demonstrates the usefulness of alternative therapies (eg, plasmapheresis) and caution in the use of beta-blockers in patients with thyroid storm.

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