Clinical features of myxedema coma include which of the following?

• A. Hyperthermia, tachycardia, hypertension, agitation
• B. Weight gain, edema, hypertension
• C. Hypothermia, bradycardia, hypotension, altered mental status
• D. Hypertension, tachypnea, leukocytosis

Answer: (C)

Myxedema coma is a severe decompensation of hypothyroidism, and its most telling picture is slowed metabolism with CNS depression. The body’s heat production collapses, so hypothermia is common. The heart slows markedly (bradycardia), reducing cardiac output, and the vascular system becomes less responsive, leading to low blood pressure (hypotension). Central nervous system function is depressed, so mental status is altered. These features together create a classic, life-threatening presentation.

While edema can occur in hypothyroidism, and some patients have weight gain, the combination of hypothermia, bradycardia, hypotension, and altered mental status is the hallmark. Hyperthermia, tachycardia, hypertension, or marked agitation would point away from myxedema coma and toward other states such as thyroid storm or different causes of shock.