CASE PRESENTATION A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the ablation, she was found to have some residual thyroid activity, negating the need for therapy. She was lost to follow-up after months of normal thyroid-stimulating hormone values. On this presentation, the patient was noted to be in atrial fibrillation with a rapid ventricular rate, and although she presented alert and oriented initially, she developed progressive inattentiveness and confusion while in the ED. The patient was transferred to the medical ICU for further management of her rapid heart rate and progressive delirium.

中文翻译：

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一位患有弥漫性肌痛、疲劳和呼吸急促的 62 岁女性

病例介绍 一名 62 岁女性，曾接受过部分治疗的格雷夫斯病和高血压病史，出现疲劳加重、下肢肌痛和呼吸急促约 3 周。她的病史包括几年前的甲状腺射频消融术。消融后，发现她有一些残留的甲状腺活动，不需要治疗。在正常促甲状腺激素值数月后，她失去了随访。在这次就诊中，患者被发现患有心房颤动并伴有快速心室率，尽管她最初表现出警觉和定向，但在 ED 期间出现了进行性注意力不集中和意识模糊。患者被转移到内科 ICU 以进一步治疗她的快速心率和进行性谵妄。