Myxedema heart disease and non-comatose presentation of myxedema: A case report.
Laura Valenzuela-VallejoLucila Emilse Folleco-OrtizDavid Corredor-OrlandelliJuan Felipe Aguirre-RuizNicolas IsazaAlex Valenzuela-RinconPublished in: SAGE open medical case reports (2022)
Myxedema coma is an emergency that develops from non-diagnosed or severe hypothyroidism and requires early recognition and management. Cardiac manifestations are uncommon and pose a challenge in the recognition of myxedema coma. We present the case of a 76-year-old male with a history of thyroidectomy secondary to a follicular carcinoma, who presented with dyspnea, generalized edema, drowsiness, disorientation, memory loss, and episodic generalized tonic-clonic seizures. Antiepileptic and diuretic treatment for seizures and heart failure exacerbation did not improve the symptoms. Further blood analysis revealed a thyroid-stimulating hormone and free thyroxine of 163 mUL/L and 0.64 ng/dL, respectively. Treatment with intravenous hydrocortisone and levothyroxine led to progressive clinical improvement. Uncommon clinical manifestations such as cardiac and non-specific neurologic symptoms should be considered as manifestations of myxedema coma. A comatose mental status is not a universal manifestation, and milder symptoms should be considered. An adequate assessment, including diagnostic scores and prompt hormonal supplementation prevents fatal consequences.
Keyphrases
- heart failure
- cardiac arrest
- left ventricular
- healthcare
- multiple sclerosis
- public health
- sleep quality
- high dose
- low dose
- working memory
- squamous cell carcinoma
- type diabetes
- replacement therapy
- early onset
- intensive care unit
- adipose tissue
- mouse model
- acute heart failure
- single cell
- case report
- palliative care
- polycystic ovary syndrome