• Soo Jin Park, KimDo JungDJDepartment of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Korea., You Sun Hong, Sang Hyun Lim, and Jiye Park.
• Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Korea.
• Medicine (Baltimore). 2022 Aug 12; 101 (32): e29359e29359.

RationaleCardiac arrest due to thyroid storm is a very rare clinical feature with high mortality that presents as multiorgan dysfunction. The mortality rate under this condition is close to 30%, even with appropriate treatment. Most thyroid storms occur in patients with long-standing untreated hyperthyroidism.Patient ConcernsA 67-year-old woman, who had no specific medical history, was admitted with stupor mentality after a pedestrian traffic accident.DiagnosisThe patient had a Burch and Wartofsky score of 80, well beyond the criteria for diagnosis of a thyroid storm (>45 points).InterventionsVenoarterial extracorporeal membrane oxygenation (ECMO) was performed due to persistent unstable vital signs and findings of right ventricular dysfunction after return of spontaneous circulation after cardiopulmonary resuscitation. Circulatory assist with ECMO was performed for 8 days using a beta blocker, steroids, thionamide, and Lugol iodine solution.OutcomesMyocardial function and thyroid hormone levels were rapidly normalized. The patient's mental state recovered, and patient was discharged on day 36 maintaining medication.LessonsDiagnosis of a thyroid storm in patients with multiple trauma is very difficult, because most trauma patients have symptoms of tachycardia, altered mental status, and abdominal pain that appear in thyrotoxic events. However, when unexplained shock without bleeding evidence occurs in patients with multiple trauma, a thyroid function test should be performed to rule out thyroid storm. Moreover, if hyperthyroidism is observed in a trauma patient, even if there is no history of hyperthyroidism, the possibility of a thyroid storm must be considered along with medical support treatment such as ECMO in patient with cardiogenic shock.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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