• Am J Emerg Med · Sep 2013

    Case Reports

    Thyroid storm and arrhythmic storm: a potentially fatal combination.

    • Diana Anjo, José Maia, André Couto Carvalho, Heloísa Castro, Irene Aragão, António Pinheiro Vieira, António Hipólito Reis, Fátima Borges, and Severo Torres.
    • Cardiology Department, Hospital Santo António - Centro Hospitalar do Porto, Porto, Portugal. Electronic address: diana_anjo@hotmail.com.
    • Am J Emerg Med. 2013 Sep 1;31(9):1418.e3-5.

    AbstractThyroid storm is a rare clinical emergency with a mortality rate between 20% and 30%. Cardiac arrhythmias associated with thyrotoxicosis are usually supraventricular. Ventricular arrhythmias are rarely associated with this entity and tend to occur in patients with intrinsic cardiac disease. We present a 35-year-old woman with Graves disease and a thyroid storm manifested with multiple malignant dysrhythmic episodes, without underlying cardiac disease. The mechanism for ventricular arrhythmia is not clear but seems to be due to the increased myocardial excitability directly caused by the thyroid hormones. The presence of myocarditis lesions may constitute an arrhythmogenic substratum and contribute further to this manifestation. This case emphasizes the importance of cardiac monitoring in patients with thyroid storm.

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