Godo Shigeo, Kawazoe Yu, Ozaki Hiroshi, Fujita Motoo, Kudo Daisuke, Nomura Ryosuke, Shimokawa Hiroaki, Kushimoto Shigeki
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan.
Department of Emergency and Critical Care Medicine, Tohoku University Hospital, Japan.
Intern Med. 2017 Oct 1;56(19):2603-2609. doi: 10.2169/internalmedicine.8846-17. Epub 2017 Sep 6.
Thyroid storm is a life-threatening disorder that remains a therapeutic challenge. Although β-blockers are the mainstay for treatment, their use can be challenging in cases complicated by rapid atrial fibrillation and decompensated heart failure. We present a case of thyroid storm-associated atrial fibrillation and decompensated heart failure complicated by gastrointestinal dysfunction secondary to diffuse peritonitis that was successfully managed by a switching therapy, in which the continuous intravenous administration of landiolol was changed to bisoprolol via transdermal patch, in the acute phase treatment. This switching therapy may offer a promising therapeutic option for this potentially lethal disorder.
甲状腺危象是一种危及生命的疾病,仍然是一个治疗挑战。尽管β受体阻滞剂是主要治疗药物,但在合并快速房颤和失代偿性心力衰竭的情况下使用它们可能具有挑战性。我们报告一例甲状腺危象相关房颤和失代偿性心力衰竭合并弥漫性腹膜炎继发胃肠功能障碍的病例,该病例在急性期治疗中通过转换疗法成功治疗,即将持续静脉输注兰地洛尔改为经皮贴片给予比索洛尔。这种转换疗法可能为这种潜在致命性疾病提供一种有前景的治疗选择。