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Myxedema heart disease and non-comatose presentation of myxedema: A case report

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 thyroidecto...

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Autores principales: Valenzuela-Vallejo, Laura, Folleco-Ortiz, Lucila Emilse, Corredor-Orlandelli, David, Aguirre-Ruiz, Juan Felipe, Isaza, Nicolas, Valenzuela-Rincon, Alex
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549094/
https://www.ncbi.nlm.nih.gov/pubmed/36225224
http://dx.doi.org/10.1177/2050313X221130227
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author Valenzuela-Vallejo, Laura
Folleco-Ortiz, Lucila Emilse
Corredor-Orlandelli, David
Aguirre-Ruiz, Juan Felipe
Isaza, Nicolas
Valenzuela-Rincon, Alex
author_facet Valenzuela-Vallejo, Laura
Folleco-Ortiz, Lucila Emilse
Corredor-Orlandelli, David
Aguirre-Ruiz, Juan Felipe
Isaza, Nicolas
Valenzuela-Rincon, Alex
author_sort Valenzuela-Vallejo, Laura
collection PubMed
description 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.
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spelling pubmed-95490942022-10-11 Myxedema heart disease and non-comatose presentation of myxedema: A case report Valenzuela-Vallejo, Laura Folleco-Ortiz, Lucila Emilse Corredor-Orlandelli, David Aguirre-Ruiz, Juan Felipe Isaza, Nicolas Valenzuela-Rincon, Alex SAGE Open Med Case Rep Case Report 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. SAGE Publications 2022-10-08 /pmc/articles/PMC9549094/ /pubmed/36225224 http://dx.doi.org/10.1177/2050313X221130227 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Valenzuela-Vallejo, Laura
Folleco-Ortiz, Lucila Emilse
Corredor-Orlandelli, David
Aguirre-Ruiz, Juan Felipe
Isaza, Nicolas
Valenzuela-Rincon, Alex
Myxedema heart disease and non-comatose presentation of myxedema: A case report
title Myxedema heart disease and non-comatose presentation of myxedema: A case report
title_full Myxedema heart disease and non-comatose presentation of myxedema: A case report
title_fullStr Myxedema heart disease and non-comatose presentation of myxedema: A case report
title_full_unstemmed Myxedema heart disease and non-comatose presentation of myxedema: A case report
title_short Myxedema heart disease and non-comatose presentation of myxedema: A case report
title_sort myxedema heart disease and non-comatose presentation of myxedema: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549094/
https://www.ncbi.nlm.nih.gov/pubmed/36225224
http://dx.doi.org/10.1177/2050313X221130227
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