What is the appropriate method for controlling heart rate in a patient with thyroid storm?

In the management of thyroid storm, the primary goal is to control the symptoms, particularly the elevated heart rate, which can lead to complications such as heart failure or arrhythmias. The use of beta-blockers is a well-established method for achieving this, as they effectively reduce heart rate and mitigate adrenergic symptoms associated with the hyperthyroid state.

Beta-blockers, particularly propranolol, are commonly employed because they block the action of catecholamines on the heart, thus reducing heart rate and myocardial oxygen consumption. Utilizing beta-blockers is particularly beneficial in this scenario as they can also help alleviate other symptoms of thyroid storm, such as anxiety, tremors, and diaphoresis.

Care should be taken when using beta-blockers in patients with underlying congestive heart failure (CHF), as they can further decrease the heart rate and contractility. However, in a patient with thyroid storm, the benefits of using beta-blockers to control the heart rate generally outweigh the risks, provided there is close monitoring and appropriate adjustments in the setting of CHF.

In contrast, calcium channel blockers primarily affect smooth muscle and may not be as effective in controlling heart rate in this setting. Digoxin is not indicated for the rapid control of heart rate in thyroid