When Liver Disease Coincides With Heart Failure: A Diagnostic Case Challenge

This case challenge explores a diagnostic dilemma in a healthy young adult presenting with sudden-onset liver disease and heart failure of an unclear etiology. Because of the complex presentation of this patient, the appropriate diagnostic tests were not initially ordered, delaying diagnosis and treatment. The nurse practitioner must critically analyze the patient's presentation and consider secondary sources causing the multisystem failure rather than isolating single body systems. Comprehensive knowledge of the variable symptomatology in the presentation of thyrotoxicosis is essential in early recognition, diagnosis, and treatment. (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).