Myxedema coma is a rare but highly lethal endocrine emergency. It usually presents with altered mental status, hypotension, bradycardia, hypothermia, bradypnea, hyporeflexia, hyponatremia, and hypoglycemia, all resulting from a profound deficiency of thyroid hormones. Additionally, affected individuals may present with signs of low cardiac output, generalized edema, shock, pericardial and/or pleural effusion, and altered mental status (with or without coma). We present three cases of patients with myxedema coma and pericardial effusion, all with unusual clinical features.
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