• Myxedema coma can closely mimic cardiogenic shock
• TSH is an inexpensive screening tool to rule out myxedema coma
• Management of myxedema coma includes airway management, IV levothyroxine, IV hydrocortisone, and supportive care
• Greater than one half of patients presenting with sepsis syndrome will have negative blood cultures
• Do not be falsely reassured by the presence of fever and leukocytosis
• Always consider RUSH exam and reconsider differential diagnosis in complex hypotensive patients!