Cardiology Department, Hospital Santo António - Centro Hospitalar do Porto, Porto, Portugal.
Am J Emerg Med. 2013 Sep;31(9):1418.e3-5. doi: 10.1016/j.ajem.2013.04.026. Epub 2013 May 23.
Thyroid 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.
甲状腺危象是一种罕见的临床急症，死亡率在 20%至 30%之间。与甲状腺毒症相关的心律失常通常为室上性。与这种情况相关的室性心律失常很少见，往往发生在有内在心脏疾病的患者中。我们报告了一例 35 岁女性患有格雷夫斯病和甲状腺危象，表现为多次恶性心律失常发作，无潜在的心脏疾病。室性心律失常的发生机制尚不清楚，但似乎是由于甲状腺激素直接引起的心肌兴奋性增加所致。心肌炎病变的存在可能构成心律失常的基质，并进一步导致这种表现。本病例强调了在甲状腺危象患者中进行心脏监测的重要性。
