Ali Hassam, Sarfraz Shiza, Hassan Lareb, Ali Hadeera
Internal Medicine, East Carolina University, Vidant Medical Center, Greenville, USA.
Anesthesiology, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, PAK.
Cureus. 2021 Sep 7;13(9):e17786. doi: 10.7759/cureus.17786. eCollection 2021 Sep.
Atrial fibrillation as an initial presenting symptom of an apathetic thyroid storm is under-reported, especially in the setting of undiagnosed hyperthyroidism. Very rarely, thyroid storm can present with apathetic symptoms. The author presents a case of apathetic thyrotoxicosis with atrial fibrillation. The patient had a generalized weakness, lethargy, and weight loss as initial symptoms and was found to have atrial fibrillation, which was initially thought to be the inciting event. However, further evaluation revealed a new diagnosis of apathetic thyroid storm secondary to uncontrolled Graves' disease. She was managed medically for thyroid storm with hopes to control the tachyarrhythmia by controlling the underlying etiology. Subsequently, her symptoms resolved, and she came back to baseline except for continued atrial fibrillation, which was rate controlled. Early recognition of an apathetic thyroid storm can prevent mortality and morbidity as it can often be missed due to atypical symptoms.
心房颤动作为淡漠型甲状腺危象的首发症状报道不足，尤其是在未诊断出甲状腺功能亢进的情况下。甲状腺危象极少以淡漠症状出现。作者报告了一例伴有心房颤动的淡漠型甲状腺毒症病例。患者最初的症状为全身无力、嗜睡和体重减轻，被发现患有心房颤动，最初认为这是诱发事件。然而，进一步评估发现了继发于未控制的格雷夫斯病的淡漠型甲状腺危象这一新诊断。她接受了甲状腺危象的药物治疗，希望通过控制潜在病因来控制快速性心律失常。随后，她的症状得到缓解，除了持续存在的心房颤动（心率得到控制）外，她恢复到了基线状态。早期识别淡漠型甲状腺危象可以预防死亡和发病，因为它常常因非典型症状而被漏诊。
