Unexpected aetiology in elderly patient presenting with acute hypercapnic coma

Abstract

In an emergency room setting, hypercapnic respiratory failure is a clinical entity infrequently encountered. It results from inadequate removal of carbon dioxide from distal alveoli. Goitre is defined as abnormal enlargement of the thyroid gland. It may cause compression of surrounding structures including trachea as thyroid dimension increases. Goitre associated with breathing difficulty is a very well-known situation. Retrosternal goitre can be misinterpreted as asthma and can lead to diagnostic delay. We report a case in which the patient with retrosternal goitre presented rarely with acute hypercapnic coma.