Key result
Intravenous adenosine successfully resolved a wide-complex tachycardia in a 44-year-old woman, leading to the diagnosis and subsequent treatment of thyroid storm and Wolff-Parkinson-White syndrome.
Case Report (n=1)
This case highlights the rare presentation of thyroid storm triggering a wide-complex tachycardia in a patient with previously undiagnosed Wolff-Parkinson-White syndrome.
Hypothesis-generating for adenosine in thyroid storm-WPW overlap; prospective data needed before practice consideration.
A 44-year-old woman with no medical history presented to the emergency department with a 2 h history of sudden onset chest pressure, palpitations, diaphoresis and shortness of breath. She reported a 90-pound unintentional weight loss, increased appetite, irritability, night sweats and palpitations for 2 months. Physical examination revealed a heart rate (HR) of 269 bpm and a blood pressure of 116/94 mm Hg. Her ECG revealed a wide-complex tachycardia with right bundle branch morphology and an HR of 265 bpm. Intravenous adenosine was administered with resolution of the arrhythmia and symptoms. Her subsequent ECG revealed sinus tachycardia with δ waves, which was consistent with Wolff-Parkinson-White (WPW) syndrome. Laboratory findings confirmed thyroid storm and treatment began with intravenous hydrocortisone, methimazole, metoprolol, amiodarone and iodine drops. Graves' disease was confirmed based on the presence of serum thyroid-stimulating hormone receptor antibody. The patient underwent successful WPW accessory tract ablation 6 weeks after initial presentation.
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Naqvi et al. (2015) conducted a case report in Thyroid storm and Wolff-Parkinson-White syndrome (n=1). Intravenous adenosine and subsequent medical/ablative therapy was evaluated on Resolution of arrhythmia and symptoms. Intravenous adenosine successfully resolved a wide-complex tachycardia in a 44-year-old woman, leading to the diagnosis and subsequent treatment of thyroid storm and Wolff-Parkinson-White syndrome.
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