IMR Press / RCM / Volume 21 / Issue 2 / DOI: 10.31083/j.rcm.2020.02.26
Open Access Case Report
Reversible bradycardia secondary to myxedema coma: case-report
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1 Creighton University School of Medicine, Department of Internal Medicine 7500 Mercy Road, Omaha, NE 68124, USA
2 Sheikh Shakhbout Medical City, Department of Internal Medicine, Abu-Dhabi, UAE
3 Division of Cardiology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA
*Correspondence: (Dana Awad)
Rev. Cardiovasc. Med. 2020, 21(2), 297–301;
Submitted: 4 March 2020 | Revised: 27 March 2020 | Accepted: 15 April 2020 | Published: 30 June 2020
Copyright: © 2020 Kousa et al. Published by IMR Press.
This is an open access article under the CC BY-NC 4.0 license

Myxedema coma occurs mostly in patients with long-standing untreated or undertreated hypothyroidism. Bradycardia is a well-known cardiac manifestation for myxedema coma; however, not all bradycardia with hypothyroidism are sinus bradycardia. Sick sinus syndrome is a group of arrhythmias caused by the malfunction of the natural pacemaker of the heart. Tachy-Brady syndrome is considered to be a type of sick sinus syndrome, where the heart alternates between tachycardia and bradycardia, and it is usually treated with pacemaker implantation along with rate slowing medical therapy. Here we report a case of an 83-year-old female who presented with myxedema coma and atrial fibrillation with tachycardia and intermittent slow ventricular response. We attempt to review the relationship between these two diseases and conclude that appropriate diagnosis of myxedema coma, may be beneficial in reducing the need for pacemaker implantation.

Atrial fibrillation with slow ventricular rate
case report
Figure 1.
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