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Revista Médica Clínica Las Condes
Article . 2024 . Peer-reviewed
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Tormenta tiroidea desencadenante de paro cardiorrespiratorio: reporte de caso

Authors: Eduardo Segovia-Vergara; Bárbara Reuse-Berner; Erick Rivera-Soto; Gabriela Ruiz-Cárcamo;

Tormenta tiroidea desencadenante de paro cardiorrespiratorio: reporte de caso

Abstract

Resumen: Introducción: La tormenta tiroidea se caracteriza por síntomas exagerados de hipertiroidismo, pudiendo ocasionar falla multiorgánica y paro cardiorrespiratorio. Es un fenómeno poco frecuente, pero con elevada mortalidad. Caso clínico: hombre de 35 años, sin antecedentes, con cuadro de 2 semanas de palpitaciones y epigastralgia, que en 24 horas presenta exacerbación importante, agregándose náuseas y diaforesis. En el traslado a urgencias presenta paro cardiorrespiratorio por asistolia, cursando posteriormente con falla multiorgánica durante su hospitalización. En base a antecedentes otorgados por la familia de una clínica hipertiroidea reciente, se plantea posible diagnóstico de tormenta tiroidea. Se ordenan pruebas tiroideas, resultando en T4 libre mayor a 7,7 ng/dl y TSH menor a 0,005 μUI/ml. Se maneja con tiamazol, hidrocortisona y propranolol, evolucionando favorablemente. Discusión y Conclusión: Es necesario un diagnóstico oportuno, pues un manejo y detección precoz disminuye complicaciones y mortalidad. Una vez sospechada, deben iniciarse medidas de reanimación y tratamiento farmacológico que disminuya los efectos de hormonas tiroideas. Abstract: Introduction: A thyroid storm is a rare but highly lethal disease. It is characterized by exaggerated symptoms of hyperthyroidism, and it can lead to multiorgan failure and cardiopulmonary arrest. Case Report: A 35-year-old man with no prior medical history presented with a two-week history of palpitations and epigastric pain, which abruptly worsened over 24 hours, accompanied by nausea and diaphoresis. During transportation to the emergency department, he experienced cardiopulmonary arrest and multiorgan failure during his hospitalization. Family reported recent hyperthyroid symptoms led to the consideration of a thyroid storm diagnosis. Thyroid function tests revealed a free T4 level greater than 7.7 ng/dl and a TSH level less than 0.005 μIU/ml. The patient was treated with thiamazole, hydrocortisone, and propranolol, showing favorable progression. Discussion and Conclusion: Opportune diagnosis of a thyroid storm is crucial, as early management and detection reduce complications and mortality. Once suspected, resuscitation measures and pharmacological treatment should be initiated to mitigate the effects of thyroid hormones.

Keywords

Paro Cardíaco, Tirotoxicosis, R, Medicine, Tormenta Tiroidea, Insuficiencia Multiorgánica

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold