University of South Dakota Sanford School of Medicine, Vermillion, South Dakota.
Avera Sacred Heart Hospital, Yankton, South Dakota.
S D Med. 2020 Dec;73(12):572-574.
Presented here is a case of thyroid storm. Thyroid storm is a rare and life-threatening pathology that requires delicate management, even at presentation. Important nuances of care are discussed, including avoidance of iodinated contrast until a thionamide has been administered and proper selection of a beta-blocker. Regarding the administration of iodinated contrast, this case is particularly interesting because pulmonary embolism was on the differential, and CT angiography of the chest was circumvented. Acute heart failure, comorbid asthma, and the necessity for transport to a larger healthcare facility complicated the selection of a beta blocker.
这里呈现的是一例甲状腺危象。甲状腺危象是一种罕见且危及生命的病症，即使在发病时也需要精细的管理。讨论了护理的重要细节，包括在给予硫脲类药物之前避免使用碘造影剂以及正确选择β受体阻滞剂。关于碘造影剂的使用，本病例尤其有趣，因为需要鉴别肺栓塞，因此避免了进行胸部 CT 血管造影。急性心力衰竭、合并哮喘以及需要转运至更大的医疗机构使β受体阻滞剂的选择变得复杂。
