Unconsciousness and Hypothermia in an Emergency, Is It Myxedema Coma?

Coma or unconsciousness is a common presentation in an emergency. Hypothermia is relatively uncommon in the emergency department (ED). Myxoedema coma is a rare complication of hypothyroidism so suspicion at the right time is crucial for prompt management and increased survival. We present a case of a 69-year-old female who presented in Emergency with h/o unconsciousness for 1 day. On examination, she appeared to be pale with generalized edema, shallow respiration, bradycardia, and hypotension with hypothermia. On asking for a detailed history there was h/o generalized swelling of the body for 1 year and difficulty in walking for 15 days. ECG s/o first-degree heart block. So considering a diagnosis of myxoedema coma, a blood sample for a thyroid function test was sent and the patient started on thyroxin treatment, steroids, and warming provided. The patient's consciousness dramatically improved with the start of treatment and she was fully conscious after 2 days.