Apathetic hyperthyroidism with recurrent pre- syncope: An apathetic diagnostic challenge

Apathetic hyperthyroidism is a rare presentation of thyrotoxicosis which is commonly seen in elderly individuals. In this condition, the classical signs of hyperthyroidism are absent irrespective of the increased thyroid hormones level. The patient presents with signs and symptoms like lethargy, weakness, loss of weight, and depression. We present a case of apathetic hyperthyroidism in a 77-year-old male patient who presented to us with complaints of intermittent anxiety attacks because of paroxysmal atrial fibrillation, weakness, fatigability and chronic depression. The patient was diagnosed as a case of apathetic hyperthyroidism with paroxysmal atrial fibrillation.