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长期未经治疗的甲状腺功能亢进症表现为甲状腺危象时的严重心血管效应。

Severe Cardiovascular Effects of Prolonged Untreated Hyperthyroidism Manifesting As Thyroid Storm.

作者信息

Hamed Mohamed, Palumbo Sarah, Mendha Taaha

机构信息

Internal Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.

出版信息

Cureus. 2022 Jun 24;14(6):e26289. doi: 10.7759/cureus.26289. eCollection 2022 Jun.

Abstract

A thyroid storm is a rare but life-threatening manifestation of thyrotoxicosis. It still remains a diagnostic challenge as there are no specific laboratory investigations or universally accepted criteria for diagnosing thyroid storms. Diagnosis is mainly based on clinical findings, evidence of hyperthyroidism, and life-threatening symptoms. A thyroid storm has a high risk of mortality mostly due to multi-organ failure and heart failure. Cardiovascular manifestations are the most common presentation of hyperthyroidism; cardiac involvement also has the potential to be the most serious complication. Management of cardiovascular manifestations should be managed aggressively to prevent long-term myocardial damage. A high index of suspicion should be maintained in young adults presenting with heart failure and arrhythmia. We present a case of potentially life-threatening cardiovascular effects of thyroid storm and management in the ICU.

摘要

甲状腺危象是甲状腺毒症一种罕见但危及生命的表现形式。由于没有特定的实验室检查或普遍认可的诊断甲状腺危象的标准,它仍然是一个诊断难题。诊断主要基于临床表现、甲状腺功能亢进的证据以及危及生命的症状。甲状腺危象主要由于多器官功能衰竭和心力衰竭而具有较高的死亡风险。心血管表现是甲状腺功能亢进最常见的症状;心脏受累也有可能是最严重的并发症。应积极处理心血管表现以预防长期心肌损伤。对于出现心力衰竭和心律失常的年轻成年人,应保持高度怀疑。我们报告一例在重症监护病房(ICU)中甲状腺危象潜在危及生命的心血管效应及处理的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c2e/9308973/9fee436416d6/cureus-0014-00000026289-i01.jpg

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