1249

This case report described a 46-year-old Caucasian female with myxedema coma, a rare and severe complication of untreated hypothyroidism, which was precipitated by an acute pulmonary embolism. Despite the low incidence of myxedema coma (0.22 per million per year), it was critical to diagnose due to its high mortality rate. The patient presented with severe symptoms including respiratory distress, hypothermia, and alopecia, and was found to have elevated thyroid-stimulating hormone levels indicative of Hashimoto’s disease. She was treated with levothyroxine, liothyronine, and hydrocortisone, leading to stabilization and extubation by the fifth hospital day. This case highlighted the unusual presentation of pulmonary embolism in myxedema coma, which is typically associated with a hypocoagulable state.