Which physical findings are characteristic of myxedema coma (crisis)?

Updated: Oct 10, 2018
  • Author: Mohsen S Eledrisi, MD, FACP, FACE; Chief Editor: George T Griffing, MD  more...
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Answer

Physical findings may include the following:

  • Hypothermia, which may not be recognized initially because many automatic thermometers do not register low body temperatures (It may be necessary to use special thermometers.)
  • Hypotension
  • Bradycardia
  • Decreased pulse pressure, normal systolic pressure, elevated diastolic pressure
  • Decreased respiratory rate
  • Periorbital puffiness
  • Macroglossia
  • Coarse or thinning hair
  • Thyroid is commonly small (Look for scar suggesting previous thyroidectomy.)
  • Slow respiratory rate
  • Signs of pleural effusion
  • Soft or distant heart sounds, diminished apical impulse, pericardial effusion
  • Abdominal distension due to ascites
  • Diminished or absent bowel sounds due to  ileus
  • Bladder distension
  • Cold extremities, nonpitting edema of the upper and lower extremities
  • Cool, pale, dry, scaly, and thickened skin
  • Dry, brittle nails
  • Ecchymoses, purpura
  • Confusion, stupor, slow speech, delayed reflexes, seizures, coma

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