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Ann Thorac Surg 2005;80:714-716
© 2005 The Society of Thoracic Surgeons

Case report

Severe Hypothyroidism After Coronary Artery Bypass Grafting

Apurba Kumar Sarma, MCh a , * , Murali Krishna, MS a , Jayakumar Karunakaran, MCh a , Praveen Kumar Neema, MD b , Kurur Sankaran Neelakandhan, MCh a

a Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
b Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India

Accepted for publication January 28, 2004.

* Address reprint requests to Dr Sarma, Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India 695 011 (Email: aks{at}sctimst.ac.in).

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.






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