Case Report

Non-comatous Myxedema Attack in an Elderly which Precipitated by Acute Coronary Syndrome and Propranolol Usage. A Case Report and Review of the Literature


  • Mustafa SEVER
  • Fidan SEVER

Received Date: 07.12.2008 Accepted Date: 12.02.2009 Eurasian J Emerg Med 2009;8(4):50-53


Myxedema coma is a rare, but severe reason of altered mental status with high mortality up to 80% in endocrine emergencies, also in noncomatose patients. The purpose of this presentation is to summarize existing patient’s data, and to discuss emergency management of to be a rare reason of noncomatous myxedema attack, which precipitated with acute coronary syndrome and β blocker usage.


In this case report, 64 year-old male patient who presented to emergency department with mental change which beginning with cold and tremor in day was reported.


The authors suspected hypothyroid and learned Captopril and Propranolol usage for acute coronary syndrome and hypertension in his past medical history. Also non ST elevation myocardial infarction was detected in emergency management. Patient treated successfully and discharged to home.


Prompt recognition and emergency medical treatment are essential for a successful outcome. Also peroral L-thyroxine sodium measure is a safety choice in non-comatous patients.

Keywords: Acute coronary syndrome, Beta blockers, Elderly, Emergency department, Myxedema