Myxedema-associated Cardiogenic Shock Treated with Intravenous Triiodothyronine
Authors: Stephen D. MacKerrow, Larry A. Osborn, Howard Levy, R. Phillip Eaton, Peter Economou
Journal: Annals of Internal Medicine (1992)

Brief Report15 December 1992Myxedema-associated Cardiogenic Shock Treated with Intravenous TriiodothyronineStephen D. MacKerrow, MD, Larry A. Osborn, MD, Howard Levy, MD, R. Phillip Eaton, MD, Peter Economou, MDStephen D. MacKerrow, MD, Larry A. Osborn, MD, Howard Levy, MD, R. Phillip Eaton, MD, Peter Economou, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-12-1014 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWe present the case of a patient who developed cardiogenic shock related to secondary hypothyroidism, which was reversed by parenteral L-triiodothyronine (T3).Case ReportAn otherwise healthy 48-year-old Hispanic woman presented with progressive exertional dyspnea, orthopnea, fatigue, cold-intolerance, and facial swelling for 2 months. She was unable to lactate after her last pregnancy.She had mild tachypnea, features of myxedema, a temperature of 36.9 °C, blood pressure of 98/67 mm Hg, and heart rate of 93 beats/min. The thyroid gland was nonpalpable. Bibasilar rales were present. Cardiac auscultation revealed an S4.Results of serum sodium, potassium, blood urea nitrogen (BUN),...References1. Ladenson P. Recognition and management of cardiovascular disease related to thyroid dysfunction. Am J Med. 1990;88:638-41. CrossrefMedlineGoogle Scholar2. RezaAbbasi MA. Congestive cardiomyopathy in hypothyroidism. West J Med. 1975;123:228-30. MedlineGoogle Scholar3. Klein I. Thyroid hormone and the cardiovascular system. Am J Med. 1990;88:631-7. CrossrefMedlineGoogle Scholar4. SantosMillerMathewWallaceCaveHinojosa ARPWWL. Echocardiographic characterization of the reversible cardiomyopathy of hypothyroidism. Am J Med. 1980;68:675-82. CrossrefMedlineGoogle Scholar5. VoraO'MalleyPetersonMcCulloughRosenthalBarnett JBSAFD. Reversible abnormalities of myocardial relaxation in hypothyroidism. J Clin Endocrinol Metab. 1985;61:269-72. CrossrefMedlineGoogle Scholar6. Becker K; ed. Principles and Practice of Endocrinology and Metabolism. Philadelphia: J.B. Lippincott Company; 1990:275. Google Scholar7. LadensonGoldenheimRidgway PPE. Rapid pituitary and peripheral tissue responses to intravenous L-triiodothyronine in hypothyroidism. J Clin Endocrinol Metab. 1983;56:1252-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the University of New Mexico, Albuquerque, New Mexico. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMyxedema ComaShock Team Approaches in Managing Cardiogenic Shock—Intersection Between Critical Care and Advanced Heart Failure and Transplant CardiologyCritical Consideration of Myxedema Coma in the Postoperative SettingMyxedema ComaThyroid EmergenciesGuidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone ReplacementComa mixedematoso em paciente com neurofibromatose tipo 1: associação raraThe dilemma, causes and approaches to avoid recurrent hospital readmissions for patients with chronic heart failureThyroid EmergenciesMyxedema Coma: A New Look into an Old CrisisThyroid hormones and cardiac arrhythmiasWhen Past Is PrologueMyxedema ComaThyroid DisordersMyxedema ComaL-thyroxine increases susceptibility of adult rats to low K + -induced ventricular fibrillation, and sinus rhythm restoration in old ratsMyocardiopathie dilatée d'origine myxœdémateuseMolecular characterization of myocardial fibrosis during hypothyroidism: evidence for negative regulation of the pro-α1(I) collagen gene expression by thyroid hormone receptorTreatment of Myxedema Coma for Emergency SurgeryCardiogenic ShockLa insuficiencia cardíaca como primera manifestación del hipotiroidismo primario familiarThyroid hormone therapy in cardiovascular diseaseThe Heart and Thyroid DiseaseThe Molecular Basis of Thyroid Hormone ActionThyroid dysfunction in the severely ill and elderlyThe thyroid and the heart. 15 December 1992Volume 117, Issue 12Page: 1014-1015KeywordsBlood urea nitrogenLactatesPotassiumPregnancyShockSodiumTachypneaTemperatureThyroidTriiodothyronine Issue Published: 15 December 1992 PDF downloadLoading ...