Arrhythmic storm in thyrotoxic crisis secondary to amiodarone

Abstract

Introduction: Thyrotoxic crisis is a serious complication that can precipitate hemodynamic instability and arrhythmic storm in patients with structural heart disease. Amiodarone, a commonly used antiarrhythmic, is a recognized trigger of thyrotoxicosis, which complicates management in patients with advanced heart failure. We describe the case of a 52-year-old man with dilated cardiomyopathy and a defibrillator with cardiac resynchronization therapy. He developed amiodarone-induced thyrotoxic crisis in the context of refractory arrhythmic storm. He was given intensive treatment with beta-blockers, hormone synthesis inhibitors, and stepped antiarrhythmic management, which achieved hemodynamic stabilization.
Conclusions: This case highlights the importance of early diagnosis of amiodarone-induced thyrotoxicosis and the need for a multidisciplinary approach to improve clinical stability and prognosis, especially in patients with advanced heart failure.