Severe hypothyroidism after coronary artery bypass grafting.
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.
Sarma
Apurba Kumar
AK
Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India. aks@sctimst.ac.in
Krishna
Murali
M
Karunakaran
Jayakumar
J
Neema
Praveen Kumar
PK
Neelakandhan
Kurur Sankaran
KS
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
D013963:Thyroid Hormones; D013974:Thyroxine