Acute myocardial infarction and thyrotoxic storm--a difficult and dangerous combination.
We describe an unusual case of acute myocardial infarction (AMI) and cardiogenic shock in a 25-year-old woman. After coronary revascularization, a thyrotoxic storm developed and the patient's cardiac failure changed into a hyperdynamic circulation without obvious changes in the patient's vital signs. This report will focus on three issues: (1) the benefit of advanced hemodynamic monitoring in circulatory unstable patients, (2) the confounding effects of untreated hyperthyroidism on the circulation, and (3) previous cancer treatment as a cause of AMI in young persons.
Opdahl
H
H
Intensive Care Unit, Division of Surgery, Ullevål University Hospital, 0407 Oslo, Norway. helge.opdahl@ulleval.no
Eritsland
J
J
Søvik
E
E
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D002407:Catheterization, Swan-Ganz; D003128:Coma / Q000150:complications; D003327:Coronary Disease / Q000150:complications; D004554:Electric Countershock; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000628:therapy; D011441:Propylthiouracil / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000150:complications; D013958:Thyroid Crisis / Q000150:complications* / Q000188:drug therapy; D013974:Thyroxine / Q000097:blood
D000305:Adrenal Cortex Hormones; D013956:Antithyroid Agents; D011441:Propylthiouracil; D013974:Thyroxine