title: Fatal thyrocardiac event.
abstract: Atrial fibrillation occurs frequently (2-20%) in chronic hyperthyroidism patients. Poorly treated thyrotoxic patients may present with a life-threatening cerebrovascular accident giving little scope to revert the situation. At times, it is difficult to make a patient euthyroid with conventional management. The definitive treatment of choice is (131)I, radioiodine. An adjusted dose of an oral anticoagulant is highly efficacious for the prevention of all types of strokes. Timely intervention by a skilled airway manager with right instruments is the key to success in airway management. A 50-year-old thyrotoxic, semiconscious male presented with a sudden onset of haemiplegia. He had chronic AF, a huge thyroid swelling with gross tracheal deviation and dilated cardiomyopathy. A CT scan showed infarction in the left middle cerebral artery territory. After initial improvement with conservative management, patient's condition deteriorated in the next 48 h. Repeat CT scan showed increase in the infarct size with haemorrhage and midline shift. Finally, he died despite all resuscitative measures.
authors.affiliation: Department of Anaesthesiology, NBMC, Sushrutanagar - 734 012, Darjeeling, West Bengal, India.
authors.forename: Samit Kumar
authors.initials: SK
authors.lastname: Khutia
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Roy
authors.forename: Mohan Chandra
authors.initials: MC
authors.lastname: Mandal
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Das