Propranolol
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Cardiogenic shock: case report A 66-year-old woman developed cardiogenic shock during treatment with propranolol for thyroid storm. The woman, who had shortness of breath after the death of her relative, was diagnosed with Takotsubo cardiomyopathy and thyroid storm. She was treated with propanolol 40mg [route not stated], along with hydrocortisone and propylthiouracil. However, within two hours of propranolol therapy, she developed a sudden cardiac arrest attributed to cardiogenic shock. The woman underwent cardiopulmonary resuscitation, which returned her spontaneous circulation. Treatment with propranolol was held until she became tachycardic and hypertensive. She was treated with esmolol drip and then transitioned to metoprolol. She was treated with saturated solution of potassium iodide [SSKI]. Her propylthiouracil therapy was tapered to a maintenance dose and treatment with hydrocortisone was weaned off. Later, she was diagnosed with Graves’ disease. Author comment: "Cardiogenic shock, a rare complication of thyroid storm, has been described with the use of betablockers [propranolol] in the setting of low output cardiac failure. The loss of the compensatory hyperadrenergic state can cause cardiac arrest a few hours after beta-blocker administration. Caution should be taken with use of long acting beta-blockers in this clinical situation and short acting agents should be considered." Lane K, et al. Takotsubo cardiomyopathy caused by thyroid storm: A fatal combination. Thyroid 29 (Suppl. 1): A125-A126 (plus poster) abstr. 357, 29 Oct 2019. Available from: URL: http://doi.org/10.1089/thy.2019.29085.abstracts 803436789 [abstract] - USA
0114-9954/19/1781-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 30 Nov 2019 No. 1781
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