On 18/8, Doctor Pham Phong Luan of the Cardiology Department at Tam Anh General Hospital in Ho Chi Minh City, reported that Hoa experienced atrial fibrillation with a heart rate reaching 190-200 beats per minute due to a thyroid storm. This is a serious complication of hyperthyroidism, accounting for about 1-2% of hospital admissions.

Thyroid storm (also known as thyrotoxic crisis) occurs when the thyroid gland releases a large amount of thyroid hormone in a short period. High levels of thyroid hormone in the body accelerate metabolism, posing a life-threatening risk. This increased metabolism requires more oxygen, forcing the heart to beat faster to compensate, leading to rapid heart rate, atrial fibrillation, and potential heart failure.

Hoa had been diagnosed with Graves' disease-induced hyperthyroidism 4 years ago, but stopped taking her medication a year ago. Her recent appendicitis triggered the thyroid storm, which can cause serious complications such as congestive heart failure, cardiac arrhythmia, and multiple organ failure.

Doctor Luan checks the patient's heart rate a few days after treatment for the thyroid storm. Photo: Ha Vu

Doctor Luan checks the patient's heart rate a few days after treatment for the thyroid storm. Photo: Ha Vu

Doctor Huynh Thanh Kieu, Head of Cardiology 1 at Tam Anh General Hospital, said that a thyroid storm can develop in patients who do not adhere to their treatment plan, like Hoa. This condition can also be triggered by thyroid surgery, trauma, infection, diabetic ketoacidosis, acute myocardial infarction, heart failure, stroke, and other factors. Pregnant women, women in labor, patients using iodine contrast agents, and those undergoing radioactive iodine therapy are also at risk.

Hoa was treated with antithyroid medication and iodine to stabilize the thyroid storm. Three hours later, her condition was under control, and doctors performed a laparoscopic appendectomy. She continued treatment for hyperthyroidism and recovered quickly, being discharged after 5 days when her ejection fraction (EF) reached over 50% and her heart rate stabilized at 90 beats per minute, with no shortness of breath. She is now taking medication and attending follow-up appointments to prevent recurrence.

According to Doctor Kieu, even with treatment, thyroid storm can be fatal in 10-30% of cases. To reduce the risk, patients need to seek immediate medical attention. Symptoms of a thyroid storm include high fever (39°C or higher), rapid heart rate (over 140 beats per minute), restlessness, irritability, anxiety, and loss of consciousness. Less common signs include nausea, severe vomiting, diarrhea, abdominal pain, jaundice, and yellowing of the eyes.

To prevent thyroid storm complications, patients with hyperthyroidism should adhere to their prescribed medication, attend scheduled checkups, manage stress, eat a healthy diet, and exercise regularly.

Thu Ha

*The patient's name has been changed.