Abstract
Hyperthyroidism is a multisystemic disease with its main effects on the cardiovascular system. It is better to control thyroid hormone excess before surgery to avoid the risk of precipitating thyroid storm. This won’t be practical in emergency or urgent surgeries. This is a case history of a 50 year old man with uncontrolled hyperthyroidism who underwent a gastrectomy for a carcinoma. Hyperthyroidism was managed with antithyroid drugs, beta blockers, glucocorticoids and magnesium sulphate.
Highlights
Hyperthyroidism is a multisystemic disease with its maineffects on the cardiovascular system
Antithyroid drugs and propranolol were continued in the perioperative period
Glucocorticoids have been used in the treatment of hyperthyroidism and thyroid storm because they have an inhibitory effect on peripheral conversion of T4 to T3.3 We used hydrocortisone preoperatively, at the induction and postoperatively for 48 hours the clinical relevance of this minor effect is unknown.[3]
Summary
Hyperthyroidism is a multisystemic disease with its maineffects on the cardiovascular system. Antithyroid drugs and propranolol were continued in the perioperative period. Intravenous hydrocortisone 200mg was given 12 hours before the surgery. On the day of the surgery standard monitoring was established with ECG with ST segment analysis, pulse oxymetry and noninvasive blood pressure.
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