Myxedema coma is a misleading misnomer. Most patients don't have non-pitting edema (myxedema), nor are they frankly comatose. The best way to think about this disease is simply decompensated hypothyroidism. Patients with under-treated or untreated hypothyroidism have no metabolic reserve. Stressors may easily push them into multi-organ failure.
Myxedema coma is easily missed, because it will generally be associated with other physiologic stressors (e.g. sepsis, cold environmental exposures, surgery, burns). This can create a confusing combination of pathophysiologies, which often won't obviously be related to the thyroid. Unfortunately, overlooking the myxedema component may have grave consequences.
The IBCC chapter is located here.
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- IBCC chapter & cast – Analgesia for the critically ill patient - August 10, 2020
- IBCC chapter & cast – Inhaled Pulmonary Vasodilators - August 8, 2020
- IBCC chapter & cast – Hyperosmolar Hyperglycemic State - August 3, 2020