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Identifying And Treating Thyroid Storm And Myxedema Coma In The Emergency Department

August 2009

Abstract

Although thyroid-related medical conditions are relatively common in the general population, the acute life-threatening thyroid emergency rarely presents. Both hyper- and hypothyroidism can contribute to the etiology of a number of critical ED presentations, ranging from acute psychosis to frank coma. With reported mortality rates ranging from 20% to 80% for the life-threatening, decompensated forms of hypo- and hyperthyroidism, myxedema and thyroid storm, respectively, it remains crucial that the emergency clinician be versed in their diagnosis and treatment.1,2

This issue of Emergency Medicine Practice reviews the fundamental principles of the management of thyroid emergencies using a focused, evidence-based approach to the literature. Although thyroid disorders constitute a wide-ranging clinical spectrum, this review will focus on the common final pathway of acutely decompensated hyper- and hypothyroidism, myxedema, and thyroid storm. Accurate diagnosis and the application of proven emergent treatments are critical in reducing the profound mortality rates related to both conditions. 
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