Esmolol Is Not the Solution: Thyroid Storm With Atrial Fibrillation

Thyroid storm is a challenging medical emergency that requires urgent assessment and management in a timely manner. In this article, we report on a case of a 37-year-old female who presented to the emergency department with a thyroid storm complicated by atrial fibrillation (AF) with a rapid ventricular response with no clinical signs of heart failure. As part of her medical management to rate control her AF, she was started on an infusion of a short-acting beta blocker, esmolol, and shortly after, she developed cardiac arrest. This is the second case report published to highlight the significant response (cardiac arrest) of patients with thyroid storm complicated by AF to a low dose esmolol infusion as part of their medical management.