"Thyroid Storm Secondary to Follicular Neoplasm of the Thyroid"

Abstract

The patient is an 80-year-old White man with a past medical history of atrial fibrillation, left ventricular hypertrophy, and hyperlipidemia who presented to the hospital at the request of his primary care provider (PCP) for discovery of atrial fibrillation with rapid ventricular response (RVR). In the patient's PCP office, he reported a three day history of palpitations, eye swelling, and presyncope. An ECG in the PCP's office revealed atrial fibrillation with a heart rate of 135 beats per minute. He was admitted to the hospital under Cardiology's service and started on 180 mg of IV Diltiazem with plan for TEE, but spontaneously converted to normal sinus rhythm while awaiting this procedure. He also started on metoprolol tartrate 50 mg PO twice daily. The patient was anticoagulated on rivaroxaban 20 mg PO QPM.