Thyroid storm presenting alongside acute congestive heart failure at Killip class III or IV is a haemodynamically critical scenario. The severity of circulatory compromise — from pulmonary oedema through to frank cardiogenic shock — directly dictates the management pathway.
This protocol applies when thyroid storm co-occurs with acute congestive heart failure classified as Killip class III or IV. At this severity, invasive haemodynamic monitoring using a Swan-Ganz catheter is recommended to guide management decisions.
Management involves respiratory support combined with vasoactive agents — including adrenergic agonists — chosen according to the patient's haemodynamic status. Additional agents addressing heart rate and cardiac rhythm may also form part of the regimen.
The complete structured protocol — agent selection, sequencing, and the specific conditions that determine each choice — is available via the link below.
Hemodynamic monitoring using a Swan-Ganz catheter is recommended for patients with acute congestive heart failure classified as Killip class ≥III.
Adrenergic agonists should be used.
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