Extreme Bradycardia During Sleep Apnea Caused by Myxedema

Daniel Abouganem, Andrew Lex Taylor, Elio Donna, George Leonard Baum

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


A 52-year-old man with myxedema was evaluated for anterior chest pain that was considered to be compatible with myocardial ischemia. The night after admission he developed extreme bradycardia, hypotension, and apneic episodes lasting up to 25 s. Continuous positive airway pressure and administration of medroxyprogesterone acetate prevented further episodes and relieved much of the somnolence and lethargy that had contributed to the evidence for myxedema. Alveolar hypoventilation caused by decreased sensitivity to carbon dioxide, inadequate central neural drive, peripheral muscle force, and obesity all may have contributed to the apnea. Chest pain has not recurred, and results of electrocardiography have remained normal following full thyroid hormone replacement. The early recognition of myxedema causing sleep apnea will allow specific treatment to avoid the cardiovascular risks related to prolonged apnea and will help avoid confusion with other etiologies of cardiovascular abnormalities.

Original languageEnglish (US)
Pages (from-to)1497-1499
Number of pages3
JournalArchives of internal medicine
Issue number8
StatePublished - Aug 1987

ASJC Scopus subject areas

  • Internal Medicine


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