2 min read - Myxedema Coma
A 75 years old lady was brought to the medical casualty ward semiconscious. Her consciousness had deteriorated over the preceding 3 days. There was no history of fever. On examination, she was overweight and had generalized edema. The pulse rate was 46/min and blood pressure was 80/50mmHg. There were bilateral basal crepitations. RBS was 130mg/dl. A bolus of IV normal saline was given, but there was no improvement of blood pressure. She was given several boluses of atropine but the response was transient and blood pressure didn't improve. What are the possibilities? In a bradycardic patient coming with a reduced level of consciousness, apart from the usual differentials such as myocardial infarction, you should always suspect less common causes. Some of them are, 1. Myxedema coma 2. Beta-blocker poisoning 3. Calcium channel blocker poisoning 4. Organophosphate poisoning What features would suggest the diagnosis of myxedema coma? Their appearance itself...