title: Emergency department management of thyrotoxic crisis with esmolol.
abstract: A previously healthy 26-year-old woman presented to the emergency department complaining of a severe, throbbing, and bifrontal headache. Initial vital signs were pulse rate, 130 beats/min; blood pressure, 128/50 mm Hg; temperature, 100.1 degrees F. Shortly thereafter the patient's pulse and temperature increased to 170 beats/min and 103 degrees F, respectively. Physical examination showed a tremulous, anxious woman in moderate distress who had a diffusely and symmetrically enlarged thyroid gland. A diagnosis of thyrotoxic crisis was made, and appropriate therapy instituted, including the use of an esmolol infusion for control of hypersympathetic activity. A review of the clinical presentation, diagnosis, and management of thyrotoxic crisis is presented.
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN 55415.
authors.forename: D D
authors.initials: DD
authors.lastname: Brunette
authors.forename: C
authors.initials: C
authors.lastname: Rothong
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D011412:Propanolamines / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use; D013958:Thyroid Crisis / Q000188:drug therapy*
chemical_list: D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; D011433:Propranolol; C036604:esmolol