Successfully treated case of severe hypothermia secondary to myxedema coma

Abstract

BackgroundMyxedema coma is an extremely rare but fatal endocrine emergency that requires urgent recognition and treatment. We describe a case of severe hypothermia that rapidly deteriorated to cardiac arrest that was attributed to myxedema coma.Case PresentationA 52‐year‐old man without a history of hypothyroidism was transferred to our emergency department due to coma and profound hypothermia. The patient developed cardiac arrest immediately after hospital arrival but return of spontaneous circulation was achieved shortly after resuscitation. The patient was noted to have generalized, nonpitting edema, dry skin, severe respiratory acidosis, hyponatremia, and elevated creatinine kinase, which was indicative of hypothyroidism. Myxedema coma was confirmed by a thyroid profile. The patient was successfully treated with intravenous levothyroxine and glucocorticoid.ConclusionAlthough myxedema coma is a rare cause of severe hypothermia, emergency physicians should be familiar with its clinical features and management.

Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent

“…Arrythmias including bradycardia, heart block, and torsade de pointes have been reported. Although uncommon, cardiac arrest primarily related to hypothyroidism has been reported in adults with myxedema coma due to undiagnosed hypothyroidism [11][12][13][14]. Intraoperative cardiac arrest potentially due to severe undiagnosed hypothyroidism was reported during a bronchoscopy in a 68-year-old man with multiple comorbid conditions including atrial fibrillation treated with amiodarone that resulted in hypothyroidism [15].…”