Thyrotoxicosis with Coronary Spasm that Required Coronary Artery Bypass Surgery

Lee, Sang Min; Jung, Tae Sik; Hahm, Jong Ryeal; Im, Sung Il; Kim, Sang-Yong; Lee, Kyeong Ju; Lee, Jae Min; Chung, Soon Il

doi:10.2169/internalmedicine.46.0472

Cited by 24 publications

(22 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thyroid storm has been reported once previously after CABG. 6 Our case has multiple features in common with the previous report, such as female sex, few risk factors for coronary artery disease, minimal preoperative evidence of thyrotoxicosis, and postoperative storm complicated by coma and a prompt response to thyroid suppression therapy. 6 The recognized triggers for thyroid storm include trauma, pregnancy, and infection.…”

Section: Discussionsupporting

confidence: 74%

“…6 Our case has multiple features in common with the previous report, such as female sex, few risk factors for coronary artery disease, minimal preoperative evidence of thyrotoxicosis, and postoperative storm complicated by coma and a prompt response to thyroid suppression therapy. 6 The recognized triggers for thyroid storm include trauma, pregnancy, and infection. [1][2][3] It is likely that the trauma of cardiac surgery triggered thyroid storm in this patient, who displayed no overt features of hyperthyroidism before the operation.…”

Section: Discussionsupporting

confidence: 74%

See 1 more Smart Citation

Thyroid storm after coronary artery bypass grafting

Bish

Bavaria

Augoustides

2010

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

We describe a 45-year-old woman with thyroid storm developing after urgent coronary artery bypass grafting (CABG). The hallmark clinical features included fever, tachycardia, depressed mental status, and jaundice. Thyroid testing confirmed severe hyperthyroidism caused by Graves disease. The patient was rendered euthyroid after initiation of therapy with methimazole (INN, thiamazole), potassium iodide, and hydrocortisone.

show abstract

Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 74%

Thyroid storm after coronary artery bypass grafting

Bish

Bavaria

Augoustides

2010

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

“…There is also a probability that he may have had undiagnosed hyperthyroidism without overt manifestations prior to this hospital encounter. To the best of our knowledge, there are only two previously reported cases of thyroid storm occurring in the setting of CABG (8,9). Our case had minimal pre-operative findings of thyrotoxicosis, no known risk factors of cardiovascular disease, post-operative thyroid storm and prompt response to treatment.…”

Section: Discussionmentioning

confidence: 98%

Post Coronary Artery Bypass Graft (CABG) Surgery Thyroid Storm: A Near Miss

Dhillon¹,

Manocha²,

Kahlon³

et al. 2017

Am J Hosp Med

View full text Add to dashboard Cite

Altered mental status (AMS) is a challenging symptom, commonly encountered in the acute hospital setting. We present a challenging case of AMS where an early assessment could have potentially prevented a complicated hospital course. A 42-year-old male presented to emergency room with chest pain. He was tachycardic, hypotensive and electrocardiogram showed new ST depressions. He underwent emergent cardiac catheterization showing triple vessel disease with placement of intra-aortic balloon pump, followed by CABG. Post-operatively he could not be extubated and had persistent fever, tachycardia and deterioration in mental status. Initial work up for fever and AMS was unremarkable. He was treated with broad spectrum antibiotics and beta blockers but remained intubated, febrile, and altered. Thyroid function tests done around second week of hospitalization revealed TSH < 0.03uU/ml, fT4 > 4.5 ng/dl, T3 411.9 ng/dl, thyroid stimulating immunoglobulin 269%. A thyroid sonogram revealed diffusely enlarged, heterogeneous and hypervascular thyroid lobes. He was started on stress doses of steroids, propylthiouracil and continued on beta blocker. Within the next 72 hours his heart rate, fever and mental status improved and he was extubated. Thyroid storm, also referred to as thyrotoxic crisis, is an acute life threatening hypermetabolic state induced by excessive release of thyroid hormones in a patient with thyrotoxicosis. It is often precipitated by an acute event such as surgery, trauma, infection or iodine load. The Burch and Wartofsky scoring system is helpful in distinguishing this from severe thyrotoxicosis. It should always be kept in the differential diagnosis of AMS, fever, tachycardia of unknown cause.

show abstract

“…The diagnosis of hyperthyroidism may be overlooked or delayed in patients without typical symptoms. Lee et al [6] reported a patient who complained of chest pain without specific syptomes of thyrotoxicosis. She was treated with emergent coronary artery bypass graft surgery due to ostial stenoses of coronary arteries on angiography.…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism-associated coronary spasm: A case of non-ST segment elevation myocardial infarction with thyrotoxicosis

Kuang

Zhang²

2012

Journal of Geriatric Cardiology

View full text Add to dashboard Cite

Hyperthyroidism is associated with many heart diseases. Thyrotoxic state has a relationship with coronary spasm. We present a case of a non-menopausal woman with hyperthyroidism who complained of chest pain. The diagnosis of coronary spasm was confirmed by coronary angiography (CAG). She is treated well with anti-thyrotoxicosis and anti-anginal medication. We recommend not use CAG as the first diagnostic choice among the patients with medication-uncontrolled hyperthyroidism and chest pain.

show abstract

Thyrotoxicosis with Coronary Spasm that Required Coronary Artery Bypass Surgery

Abstract: We describe a 47-year-old

Cited by 24 publications

References 18 publications

Thyroid storm after coronary artery bypass grafting

Thyroid storm after coronary artery bypass grafting

Post Coronary Artery Bypass Graft (CABG) Surgery Thyroid Storm: A Near Miss

Hyperthyroidism-associated coronary spasm: A case of non-ST segment elevation myocardial infarction with thyrotoxicosis

Contact Info

Product

Resources

About