Which symptom best indicates thyroid storm in the post-thyroidectomy setting?

Which symptom best indicates thyroid storm in the post-thyroidectomy setting?

• A. Hypotension
• B. Fever With Tachycardia and Hypertension
• C. Bradycardia
• D. Hypothermia

Answer: (B)

Thyroid storm is an extreme thyrotoxic crisis driven by a surge in thyroid hormone effects with heightened sympathetic activity. After thyroidectomy, it can occur when thyroid hormone release is abrupt or residual hormone activity is amplified by surgical stress. The most telling sign is fever with tachycardia and hypertension because the massive thyroid hormone effect drives a hypermetabolic state and strong adrenergic stimulation: heat production rises, the heart rate speeds up to meet metabolic demands, and blood pressure elevates from increased cardiac output and vascular tone. This constellation—fever plus rapid heart rate and high blood pressure—best captures the stormy, adrenergic-dominant picture. Hypotension, bradycardia, and hypothermia are not typical of thyroid storm and point toward other conditions such as shock, hypothyroidism, or environmental factors.

Thyroid storm is an extreme thyrotoxic crisis driven by a surge in thyroid hormone effects with heightened sympathetic activity. After thyroidectomy, it can occur when thyroid hormone release is abrupt or residual hormone activity is amplified by surgical stress. The most telling sign is fever with tachycardia and hypertension because the massive thyroid hormone effect drives a hypermetabolic state and strong adrenergic stimulation: heat production rises, the heart rate speeds up to meet metabolic demands, and blood pressure elevates from increased cardiac output and vascular tone. This constellation—fever plus rapid heart rate and high blood pressure—best captures the stormy, adrenergic-dominant picture. Hypotension, bradycardia, and hypothermia are not typical of thyroid storm and point toward other conditions such as shock, hypothyroidism, or environmental factors.