English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

We reported a case of patient after mitral valve replacement (MVR) with pulmonary hypertension (PH) and thyroid storm that is rare, but life-threatening condition. Case Illustration: A 57-year-old-male with a subclinical hyperthyroidism underwent MVR due to severe mitral regurgitation (MR) and high possibility for PH. He showed atrial fibrillation with normal left ventricular ejection fraction (LVEF). In the intensive care unit (ICU), four hours postoperatively, he developed thyroid storm with heart rate of 226 times/min, temperature 39oC, and thyroid function showed low TSH (&lt;0.05 uIU/mL), high fT4 (25.4 pmol/L), and high T3 (3.3 nmol/L). He was administered with propranolol, propylthiouracil, hydrocortisone, and lugol. Discussion: Trauma of cardiac surgery might trigger thyroid storm in this patient. The post-operative period represented a high-risk time for PH patients, moreover with thyroid storm. Therapy for thyroid storm was multimodal, including anti-thyroid, beta blockers, iodine, and glucocorticoid. Hemodynamic goals were avoidance of elevation in pulmonary vascular resistance (PVR), avoidance of myocardial depressants and maintenance of systemic vascular resistance (SVR), myocardial contractility and preload. Conclusion: Thyroid storm and PH complicating MVR was rare, but life-threatening. Comprehensive management could decrease morbidity and mortality of thyroid storm. Keywords: mitral valve replacement surgery; pulmonary hypertension; thyroid storm

Management in Mitral Valve Replacement with Pulmonary Hypertension and Thyroid Storm: A Case Report