This case suggests that lymphocytic myocarditis may be an underlying cardiac pathology contributing to fatal refractory congestive heart failure in patients with thyroid storm.
May link myocarditis to refractory HF in thyroid storm; hypothesis-generating and needs confirmation.
Cardiac failure is the leading cause of mortality in patients with thyroid storm. But the underlying cardiac pathology is unclear. Here, we report a 46-year-old woman who presented with hyperpyrexia and sinus tachycardia subsequent to accidental neck contusion. Her hyperthyroidism was verified by abnormal biochemical changes. Despite vigorous antithyroid treatment including a beta-blocker, glucocorticoid and potassium iodide, the patient eventually succumbed to refractory congestive heart failure in 4 days. Autopsy revealed lymphocytic myocarditis. We propose that lymphocytic myocarditis played a prominent role in her demise.
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Chen et al. (2010) studied this question.
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