Myxedema heart disease is an exceptionally rare condition with few reported cases. We present a rare case of a child who presented with severe congestive heart failure secondary to myxedema heart disease complicated by preexisting valvular heart disease. The patient was admitted to the pediatric intensive care unit and medical management. An echocardiogram showed severe biventricular dysfunction and severe valvular disease. She was started on levothyroxine and liothyronine. During the patient's hospitalization, the thyroxine level normalized but the thyroid-stimulating hormone continued to remain elevated. Likewise, her cardiac ventricular function improved, though it did not return to baseline. Our case highlights the importance of maintaining a broad differential diagnosis in a child who presents with congestive heart failure, to include thyroid disease, which necessitates a rare but specific management strategy.

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, and Department of Defense or the U.S. Government. No funding was received for this research.

Dr. Bennett and Dr. Bridwell contributed to conception and design and drafted the initial manuscript, and reviewed and revised the manuscript.

Dr. Percival, Dr. Appachi, Dr. Gupta-Malhorta, and Dr. Salameh contributed to conception and design, acquisition of data, analysis and interpretation of data and critically reviewed the manuscript for important intellectual content.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Work performed at : The Children's Hospital of San Antonio, 333 N Santa Rosa St, San Antonio, TX 78207.

Received: 26 February 2023

Accepted: 20 March 2023

Article published online:
28 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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