title: Severe hypothyroidism after coronary artery bypass grafting.
abstract: A 56-year-old man with unstable angina underwent urgent coronary artery bypass grafting. The patient required reintubation and prolonged ventilation because of persistent drowsiness and hypotension. The patient was weaned off the ventilator and extubated; however, he remained drowsy and lethargic. Neurologic examination, electroencephalogram, and computed tomography scan of the brain did not show any organic cause of his depressed neurologic status. His metabolic profile revealed severe hypothyroidism. The patient responded well to oral thyroxine. We report the unusual manner in which hypothyroidism presented in the patient. A high index of suspicion is required to diagnose and treat this complication.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India. aks@sctimst.ac.in
authors.forename: Apurba Kumar
authors.initials: AK
authors.lastname: Sarma
authors.forename: Murali
authors.initials: M
authors.lastname: Krishna
authors.forename: Jayakumar
authors.initials: J
authors.lastname: Karunakaran
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Neema
authors.forename: Kurur Sankaran
authors.initials: KS
authors.lastname: Neelakandhan
mesh_terms: D000789:Angina, Unstable / Q000601:surgery; D003244:Consciousness Disorders / Q000209:etiology; D001026:Coronary Artery Bypass; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013963:Thyroid Hormones / Q000627:therapeutic use; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D013963:Thyroid Hormones; D013974:Thyroxine