High-output congestive heart failure: a potentially deadly complication of thyroid storm

Hyperthyroidism, thyrotoxicosis and thyroid storm are a continuum of disease. A life-threatening and potentially fatal manifestation of thyrotoxicosis is thyroid storm. Thyroid storm is considered rare with an occurrence rate of 1-2% of all patients with hyperthyroidism, making a high index of suspicion important in the early recognition of this debilitating complication. We present the case of a 63-year-old female with a significant history of being non-compliant with her hyperthyroidism regimen and presented to the emergency department in severe respiratory distress. She was ultimately diagnosed with thyroid storm induced high-output congestive heart failure, intubated, had a cardiac arrest and was transferred to the intensive care unit in a guarded condition. Her hospital course was unremarkable and she was discharged on Day 12.