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- Title
Myxedema heart disease and non-comatose presentation of myxedema: A case report.
- Authors
Valenzuela-Vallejo, Laura; Folleco-Ortiz, Lucila Emilse; Corredor-Orlandelli, David; Aguirre-Ruiz, Juan Felipe; Isaza, Nicolas; Valenzuela-Rincon, Alex
- Abstract
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.
- Subjects
SYMPTOMS; HEART diseases; COMA; EPILEPSY; SEIZURES (Medicine); MEMORY loss; HEART failure
- Publication
SAGE Open Medical Case Reports, 2022, Vol 10, p1
- ISSN
2050-313X
- Publication type
Case Study
- DOI
10.1177/2050313X221130227