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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
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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.

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.

Ann Intern Med. 1992;117(12):1014-1015. doi:10.7326/0003-4819-117-12-1014
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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),


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Treatment of myxedema-associated cardiogenic shock. Ann Intern Med 1993;119(2):168; author reply 169.
Treatment of myxedema-associated cardiogenic shock. Ann Intern Med 1993;119(2):168-9.
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