Weathering the storm: beta-blockade and the potential for disaster in severe hyperthyroidism.
Some patients with advanced thyrotoxicosis have occult cardiac dysfunction. The use of long-acting beta-blockers, traditional in the management of thyrotoxicosis, may have disastrous consequences in this setting. The following report documents the cardiovascular collapse and asystolic arrest of a patient with hyperthyroidism when treated with sotolol. Though the patient was successfully resuscitated, the long duration of action of sotolol necessitated prolonged inotropic and vasopressor support. A shorter acting beta-blocker, such as esmolol, theoretically may be a safer option.
Fraser
T
T
Emergency Department, Geelong Hospital, Geelong, Victoria, Australia. sweenytodd@ozemail.com.au
Green
D
D
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D008875:Middle Aged; D013971:Thyrotoxicosis / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists