A middle aged female with no PMHx presents with anxiety and palpitations, found to have mild sinus tachycardia (HR 129) without evidence of thyroid storm.
1) Thyroid storm is a CLINICAL diagnosis that requires AMS + FEVER. TSH/T4/T3 levels do not help distinguish storm from other hyperthyroid conditions.
2) The two most common causes of hyperthyroidism are GRAVES and THYROIDITIS. Time course helps distinguish these (Graves is chronic, Thyroiditis acute to subacute)*
There was a great review article on Hyperthyroidism in The Lancet this year (see attached)