THE VALUE OF BEDSIDE ULTRASOUND IN THE DIAGNOSIS OF THYROTOXICOSIS AND THYROTOXIC CARDIAC EMERGENCIES- A SHORT-TERM STUDY

Abstract

Muhammed Mushthaque P 1 , Kunhi Kannan

BACKGROUND Many times in ICU patient’s thyrotoxicosis is suspected and its diagnosis is hindered by many fallacies of clinical examination and lab reports. This happens especially with cardiac emergencies. The role of Ultrasound examination of thyroid in ICU patients admitted for different causes needs to be studied elaborately. AIM To assess the thyrotoxic burden in the ICU of suspected thyroid disease in patients; find out the benefit of thyroid ultrasound in evaluating thyrotoxicosis in patients of cardiac emergency. MATERIALS AND METHODS 94 patients admitted in 2 ICU units from November 2015 to October 2016 were evaluated. Irrespective of the cause for admission to ICU all the patients suspected to have Thyrotoxicosis on clinical and lab values were assessed with Ultrasound examination of the Thyroid. All patients were subjected to Thyroid function tests, and volumetry of both lobes of thyroid. Echocardiography and continuous ECG monitoring was done. RESULTS 94 patients admitted to ICU, 67.02% had cardiogenic cause for admission. 56.38% of the total 94 patients were suspected to have thyrotoxicosis depending upon their clinical and lab features. 27.65% of these were confirmed later of Thyrotoxicosis. 47.61% of the thyroid suspicion patients had cardiogenic cause for their admission. 17 patients had grave’s disease and 9 patients showed thyroid nodule. The sensitivity of thyroid USG in diagnosis of thyrotoxicosis was 100%. CONCLUSION Bedside USG is a quick and very valuable noninvasive investigation in early, rapid and accurate diagnosis of thyrotoxicosis and thyrotoxicosis emergencies.

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