Expanding the role of ivabradine in thyrotoxic crisis: a case report and Insights from the Literature.
Ali Ibrahim Yassine, Lara do Norte Garcia, Akemi Osawa et al.
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Case in brief
A 39-year-old woman with alemtuzumab-induced Graves’ disease developed thyroid storm with persistent sinus tachycardia despite high-dose propranolol. Ivabradine was started and reduced her heart rate within 24 hours without hypotension or bradyarrhythmia. The resulting stabilization enabled definitive radioiodine treatment.
What made this case unusual
The tachycardia was refractory to high-dose propranolol, while ivabradine controlled the heart rate without hypotension or bradyarrhythmia in the setting of thyroid storm.
Diagnostic / clinical pearl
In thyroid storm with sinus tachycardia unresponsive to beta-blockade, this case illustrates ivabradine as a possible heart-rate-control option that did not lower blood pressure or cause bradyarrhythmia.
Why it matters
The authors note that evidence for ivabradine in thyrotoxic tachycardia remains limited, underscoring the need for further research to define its role.