Thyroid storm is a rare but potentially life-threatening form of thyrotoxicosis. The presence of excessive thyroid hormones leads to toxic direct and indirect effects on the cardiovascular system resulting in entity known as thyrotoxicosis-induced cardiomyopathy (TCM). The end stage of TCM results in cardiorespiratory failure from cardiogenic shock and pulmonary edema. Such outcomes have been rescued through mechanical circulatory support via extracorporeal membrane oxygenation (ECMO). We describe a case of a previously healthy 35-year-old female who presented de-novo in thyroid storm and rapid atrial fibrillation, arrested within hours of presentation, was placed emergently on extracorporeal cardiopulmonary resuscitation (ECPR) via veno-arterial ECMO, and made a full neurological and cardiac recovery. TCM can be very challenging to treat medically with spiralling effects of tachyarrhythmia and worsening cardiac output leading to decompensated heart failure. TCM is often reversible once euthyroid physiology is achieved. It also appears to affect relatively younger patients with the average age of about 50 years. Mechanical support through means of ECMO should be strongly considered in patients presenting in cardiorespiratory failure from thyroid storm in ECMO-capable centres. 

Thyroid storm, Cardiac arrest, Extracorporeal membrane oxygenation