Cardiac Arrest as First Presentation of Thyroid Storm

Abstract

Thyroid storm is a life-threatening condition characterized by a high level of circulating thyroid hormones and harbors high mortality and morbidity, even if diagnosed and treated early. The condition is frequently overlooked and under-recognized in emergency departments owing to its rarity. Here, we present a case of a 24-year-old male patient, previously healthy, who presented with cardiac arrest and was found to have heart failure and high thyroid hormone levels after investigations. Consequently, the presentation was attributed to thyroid storm. His clinical status and cardiac function improved after treatment of the hyperthyroidism.

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

“…A heart rate above 130 bpm has been reported in three-quarters of patients with thyrotoxic crisis [2]. However, AF is the most common arrhythmia in thyrotoxicosis, with a prevalence of 15%, and is typically of the persistent type rather than paroxysmal [179,248]. This was due to the pathological acceleration of diastolic depolarization of the sinoatrial node caused by the shortened action potential.…”

“…J-point elevation on ECG in TS: Although early repolarization (elevation of the QRS-ST junction (i.e., J-point elevation)) in at least two electrocardiographic leads is a common benign finding, it can be an arrhythmogenic substrate leading to VF [179]. J-point elevation represents a transmural voltage gradient between the endocardium and epicardium during ventricular electrical activation.…”