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Cardiac surgery in patients with active thyrotoxicosis carries substantially increased perioperative risks. We report a case of urgent coronary artery bypass grafting (CABG) in a 43-year-old man with severe biochemical thyrotoxicosis and critical left main coronary artery disease who presented with non-ST-segment elevation myocardial infarction. Urgent off-pump CABG was performed with intra-aortic balloon pump support. Within 48 hours of surgery, the patient developed a thyroid storm characterized by fever (40 °C), tachycardia (140-180 beats/min), encephalopathy, and jaundice. The condition was successfully treated with anti-thyroid drugs and intravenous hydrocortisone. The patient recovered fully and was euthyroid at follow-up. Early recognition and prompt multidrug treatment of postoperative thyroid storm are life-saving.
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Sathanantham et al. (2026) studied this question.
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