Location
Philadelphia, PA
Start Date
17-4-2026 1:30 PM
End Date
17-4-2026 2:30 PM
Description
Background: Thyroid storm is a life-threatening endocrine emergency with well-documented cardiovascular complications. However, the specific complication of cardiac arrest in the setting of thyroid storm remains poorly characterized in the literature, with no established clinical pathways or management algorithms to guide clinicians. This scoping review aims to identify trends and patterns in the management and outcomes of this rare but potentially survivable complication to inform future guidelines.
Methods: A scoping review of case reports was conducted in accordance with PRISMA-ScR guidelines. A comprehensive literature search was performed across PubMed, Scopus, and Embase using terms combining thyroid storm or thyrotoxicosis with cardiac arrest, ventricular fibrillation, or asystole. Following completion of the scoping search and screening process, one additional case report was identified outside of the formal search criteria. It was included given its direct relevance to the clinical question under investigation, specifically documenting cardiac arrest in the setting of thyroid storm. In total, 45 case reports comprising 48 patients were included for analysis.
Results: Overall mortality was 31.2%, with 68.8% of patients surviving to discharge despite experiencing cardiac arrest. Notably, 86% of cardiac arrests were temporally associated with beta-blocker administration. A clinically meaningful difference in mortality was observed between patients who received beta-blockers (32.6%) versus those who did not (14.3%), with an odds ratio of 2.90 (p=0.66), likely reflecting insufficient statistical power rather than a true absence of effect. An unexpected finding was substantially lower mortality associated with propranolol (8.3%) compared to short-acting beta-blocking agents (50%). Extracorporeal therapies, including ECMO, therapeutic plasma exchange (TPE), and continuous renal replacement therapy (CRRT), emerged as potentially lifesaving interventions, with prior literature suggesting cardiac recovery can occur relatively rapidly once thyroid hormone excess is controlled.
Embargo Period
6-2-2026
Included in
Cardiac Arrest in Thyroid Storm: Characterizing a Rare but Survivable Emergency
Philadelphia, PA
Background: Thyroid storm is a life-threatening endocrine emergency with well-documented cardiovascular complications. However, the specific complication of cardiac arrest in the setting of thyroid storm remains poorly characterized in the literature, with no established clinical pathways or management algorithms to guide clinicians. This scoping review aims to identify trends and patterns in the management and outcomes of this rare but potentially survivable complication to inform future guidelines.
Methods: A scoping review of case reports was conducted in accordance with PRISMA-ScR guidelines. A comprehensive literature search was performed across PubMed, Scopus, and Embase using terms combining thyroid storm or thyrotoxicosis with cardiac arrest, ventricular fibrillation, or asystole. Following completion of the scoping search and screening process, one additional case report was identified outside of the formal search criteria. It was included given its direct relevance to the clinical question under investigation, specifically documenting cardiac arrest in the setting of thyroid storm. In total, 45 case reports comprising 48 patients were included for analysis.
Results: Overall mortality was 31.2%, with 68.8% of patients surviving to discharge despite experiencing cardiac arrest. Notably, 86% of cardiac arrests were temporally associated with beta-blocker administration. A clinically meaningful difference in mortality was observed between patients who received beta-blockers (32.6%) versus those who did not (14.3%), with an odds ratio of 2.90 (p=0.66), likely reflecting insufficient statistical power rather than a true absence of effect. An unexpected finding was substantially lower mortality associated with propranolol (8.3%) compared to short-acting beta-blocking agents (50%). Extracorporeal therapies, including ECMO, therapeutic plasma exchange (TPE), and continuous renal replacement therapy (CRRT), emerged as potentially lifesaving interventions, with prior literature suggesting cardiac recovery can occur relatively rapidly once thyroid hormone excess is controlled.