Severe bradycardia at acute medical take - Think about myxoedema coma.

J R Coll Physicians Edinb

Department of Endocrinology, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK.

Published: June 2024

AI Article Synopsis

  • Two patients with myxoedema coma were initially misdiagnosed with severe bradycardia as a heart issue and referred to a cardiology unit.
  • Upon arrival, thyroid function tests revealed the correct diagnosis of myxoedema coma.
  • Despite treatment, both patients tragically died, underscoring the importance of recognizing this condition even with advanced thyroid testing available.

Article Abstract

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.

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Source
http://dx.doi.org/10.1177/14782715241244840DOI Listing

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