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Amiodarone-Induced Myxedema Coma
Armaghan Raeouf1, Siddarth Goyal2, Jeremy Traylor2
1Department of Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
Cureus
|August 28, 2020
Summary
Amiodarone can cause myxedema coma, a serious thyroid condition. Prompt thyroid panel testing and treatment are crucial for patients on long-term amiodarone therapy presenting with concerning symptoms.
Area of Science:
- Cardiology
- Endocrinology
- Emergency Medicine
Background:
- Amiodarone, a potent Class III antiarrhythmic, effectively treats supraventricular and ventricular arrhythmias.
- Amiodarone is known to cause thyroid dysfunction, potentially leading to myxedema coma in undiagnosed individuals.
- Amiodarone-induced myxedema coma presents a diagnostic challenge in emergency settings.
Observation:
- A 71-year-old male on amiodarone presented with unresponsiveness, bradycardia, and syncope.
- Initial work-up revealed hypothermia, significantly elevated thyroid-stimulating hormone (TSH), and low free thyroxine (fT4).
Findings:
- The patient's presentation was consistent with amiodarone-induced hypothyroidism and myxedema coma.
- Thyroid function tests are essential for diagnosing amiodarone-induced myxedema coma.
Implications:
- Early recognition and thyroid panel assessment are vital for patients on long-term amiodarone.
- Timely diagnosis and treatment of amiodarone-induced myxedema coma can be life-saving.
- This case underscores the importance of considering drug-induced thyroid dysfunction in emergency medicine.
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