甲状腺风暴(TS)是一种罕见且致命的内分泌紧急情况,由于甲状腺疾病患者的压力状况后未诊断和治疗不充分的甲状腺功能亢进而发生。本系统范围综述的目的是更好地了解TS的病理生理学及其并发症,就心肌影响而言,快速性心律失常,和心源性休克.此外,我们探索了药理学,机械,和TS的手术治疗。我们还根据性别和心脏受累评估了TS的结局。此外,对选定的数据进行分析分析.使用医学术语彻底进行了同行评审期刊的文献综述,MeSH在PubMed上,谷歌学者,以及甲状腺毒症诱发的心肌病等组合,甲状腺风暴,心源性休克,心肌梗塞,内分泌急症,Burch-Wartofsky得分,体外循环支持,甲状腺切除术.共有231篇论文符合条件(2篇回顾性研究,5个案例系列,和224例病例报告),在2003年4月至2023年8月之间,共有256例TS患者患有心脏受累。所有年龄组,性别,TS诱发的心肌病患者,非动脉粥样硬化性心肌梗死,快速性心律失常,心力衰竭,震惊,并讨论了不同的治疗形式。非英语文章,没有心脏受累的病例,未指明治疗方式的病例被排除.女性占主导地位,154名女性患者和102名男性患者。大约82%的患者接受了β受体阻滞剂(BBs),16.3%被放置在体外膜氧合(ECMO)支持上,16.3%接受治疗性血浆置换(TPE),13.8%接受了连续性肾脏替代治疗(CRRT),连续静脉-静脉血液滤过(CVVHD),或透析。总的来说,18名女性和16名男性死亡。BB引起的循环崩溃,急性肾功能衰竭,CRRT,和心室纤颤与死亡率显著相关。对TS的认识不仅是甲状腺毒症对于及时和适当的治疗至关重要。心脏环境中TS的早期诊断和管理,包括药理学,机械,和手术方式,可以挽救高危患者。演示文稿中的性问题,治疗,和这个人口的死亡率。然而,进一步大规模,和精心设计的研究是必需的。
Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The objective of this systematic scoping review was to better understand the pathophysiology of TS and its complications, in terms of myocardial affection,
tachyarrhythmia, and cardiogenic shock. In addition, we explored the pharmacological, mechanical, and surgical treatments for TS. We also evaluated the outcomes of TS according to sex and cardiac involvement. Additionally, analytical analysis was performed on the selected data. A literature review of peer-reviewed journals was carried out thoroughly using medical terms, MeSH on PubMed, Google Scholar, and combinations such as thyrotoxicosis-induced cardiomyopathy, thyroid storm, cardiogenic shock, myocardial infarction, endocrine emergency, Burch-Wartofsky score, extracorporeal circulatory support, and thyroidectomy. A total of 231 papers were eligible (2 retrospective studies, 5 case series, and 224 case reports) with a total of 256 TS patients with cardiac involvement between April 2003 and August 2023. All age groups, sexes, patients with TS-induced cardiomyopathy, non-atherosclerotic myocardial infarction,
tachyarrhythmia, heart failure, shock, and different forms of treatment were discussed. Non-English language articles, cases without cardiac involvement, and cases in which treatment modalities were not specified were excluded. Female sex was predominant, with 154 female and 102 male patients. Approximately 82% of patients received beta-blockers (BBs), 16.3% were placed on extracorporeal membrane oxygenation (ECMO) support, 16.3% received therapeutic plasma exchange (TPE), and 13.8% underwent continuous renal replacement therapy (CRRT), continuous venovenous hemofiltration (CVVHD), or dialysis. Overall, 18 females and 16 males died. BB-induced circulatory collapse, acute renal failure, CRRT, and ventricular fibrillation were significantly associated with mortality. Awareness of TS and not only thyrotoxicosis is vital for timely and appropriate treatment. The early diagnosis and management of TS in cardiac settings, including pharmacological, mechanical, and surgical modalities, can save high-risk patients. Sex matters in the presentation, treatment, and mortality of this population. However, further large-scale, and well-designed studies are required.