Myxedema Coma: A New Look into an Old Crisis

Table 1

Clinical and laboratory features of myxedema crisis.

Cardiovascular	Neuropsychiatric
Bradycardia and hypotension	Confusion and obtundation
Cardiomegaly	Lethargy
Low cardiac output	Coma
Pericardial effusion	Seizures
Cardiogenic shock	Poor cognitive function
Bundle branch blocks and arrhythmias	Depression and psychosis
Nonspecific ECG findings
Respiratory	Renal and water metabolism
Hypoxia	Fluid retention
Hypercarbia	Anasarca
Myxedema of larynx	Hyponatremia
Pleural effusion	Bladder atony
Pneumonia (precipitating factor)	Urine sodium normal or increased
	Urine osmolality > serum osmolality
Gastrointestinal	Metabolic
Anorexia and nausea	Hypothermia
Abdominal pain	Hypoglycemia
Constipation
Paralytic ileus
Toxic megacolon
Gastric atony
Neurogenic oropharyngeal dysphagia