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Myxedema-associated Cardiogenic Shock Treated with Intravenous Triiodothyronine
- Stephen D. MacKerrow, MD;
- Larry A. Osborn, MD;
- Howard Levy, MD;
- R. Phillip Eaton, MD; and
- Peter Economou, MD
Excerpt
We present the case of a patient who developed cardiogenic shock related to secondary hypothyroidism, which was reversed by parenteral L-triiodothyronine (T3).
Case Report An 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),
Acknowledgments
Acknowledgments: The authors thank Ms. Sharon Binyon for preparation of this manuscript.
Article and Author Information
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From the University of New Mexico, Albuquerque, New Mexico. For current author addresses, see end of text.
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Requests for Reprints: Larry A. Osborn, MD, University of New Mexico School of Medicine, Department of Internal Medicine, Albuquerque, NM 87131.
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Current Author Addresses: Drs. Osborn, Economou, Levy, and Eaton: University of New Mexico School of Medicine, Department of Internal Medicine, Albuquerque, NM 87131.
Dr. MacKerrow: Pueblo Cardiology Associates, 459 West 17th Street, Pueblo, CO 81003.
