Severe bradycardia at acute medical take – Think about myxoedema coma

We report two cases of myxoedema coma that presented to the acute medical take with severe bradycardia. These patients were initially misdiagnosed as bradyarrhythmia of primary cardiac origin. They were then diverted to the cardiology service at another district general hospital (DGH) for admissions...

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Bibliographic Details
Published in:Journal of the Royal College of Physicians of Edinburgh 2024-06, Vol.54 (2), p.133-137
Main Authors: Maung, Aye Chan, Brain, Henrietta, Ballav, Chitrabhanu, Sihota, Sarbpreet
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Bradycardia - diagnosis
Bradycardia - etiology
Coma - etiology
Diagnosis, Differential
Diagnostic Errors
Fatal Outcome
Female
Humans
Male
Middle Aged
Myxedema - diagnosis
Thyroid Function Tests
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Summary:We report two cases of myxoedema coma that presented to the acute medical take with severe bradycardia. These patients were initially misdiagnosed as bradyarrhythmia of primary cardiac origin. They were then diverted to the cardiology service at another district general hospital (DGH) for admissions. Both cases were subsequently diagnosed with myxoedema coma having screened thyroid function tests on arrival at the cardiology unit. Despite being treated for myxoedema coma, both patients unfortunately succumbed to the disease and later died in the hospital. These cases highlight that clinical suspicion and recognition of myxoedema coma remain significant challenges in a developed world despite readily available and highly sensitive thyroid hormone assays.
ISSN:1478-2715
2042-8189
2042-8189
DOI:10.1177/14782715241244840