Myxedema Coma Complicated with Cardiac Arrest: A Case Report

Myxedema coma is an extreme and uncommon manifestation of hypothyroidism with a high mortality rate of 25-60%. The hallmark features of myxedema coma include profound alteration in mental status, hypothermia, and respiratory depression. Diagnosis of myxedema coma is mainly based on clinical suspicion along with elevated TSH levels. The most common precipitative factors are discontinuation of thyroxine treatment and infection. The mainstay of treatments are thyroxine and glucocorticoids. Prompt recognition and initiation of treatment are critical for improving outcomes in affected individuals. This case report is based on a patient who presented with altered mental status, hypothermia, hypotension, bradycardia, and respiratory depression and on examination, was found to have facial puffiness, brittle hair and non-pitting oedema. Blood tests revealed severe hypothyroidism. After hospital admission, the patient went into cardiac arrest. CPR was given and ROSC was achieved. The patient was admitted to ICU and successfully managed with oral thyroxine and IV glucocorticoids.