Mechanical circulatory support for thyrotoxicosis-induced cardiomyopathy.

Thyroid storm is a life-threatening condition which, in rare cases, may lead to cardiogenic shock and dysrhythmias. Mechanical circulatory support with an Impella device or extracorporeal membrane oxygenation may be used as a bridge to recovery in these cases. This case involves a patient with thyrotoxicosis and reduced ejection fraction and hemodynamic instability requiring Impella device placement. After treatment with methimazole, Lugol's iodine, and hydrocortisone, he was weaned off mechanical circulatory support and made a full recovery. Mechanical circulatory support devices can be a useful bridging tool in reversible causes of cardiogenic shock, such as thyroid storm.

Optimal cardiovascular medical therapy: current guidelines and new developments.

Coronary artery disease is a leading cause of mortality worldwide, and patients with obstructive coronary artery disease require optimal cardiovascular medical therapy along with lifestyle modification for secondary prevention of future cardiac events. Optimal medical therapy includes antiplatelet agents, high-intensity statins, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, aldosterone antagonists, and calcium channel blockers. There are differences in the medical therapy guidelines of the American Heart Association/American College of Cardiology and the European Society of Cardiology. In addition, there are emerging medical therapies that may be added to future guidelines with additional cardiovascular outcome benefits.

Dermatomal rash after Shingrix vaccination: cause or coincidence?

Dermatological reactions have been reported following Shingrix vaccine administration in previous published cases, but dermatomal rash after Shingrix vaccination has not been reported in the United States. This case describes a 73-year-old immunocompetent woman with a dermatomal rash after Shingrix recombinant vaccine administration. This case highlights the rare possibility of an acute reaction after Shingrix vaccine administration, which should be recognized. Nonetheless, the vaccine has been shown to be very effective at preventing varicella zoster virus reactivation and postherpetic neuralgia, so the benefit of receiving the vaccination significantly outweighs the risk.