RESUMEN
Background-Respiratory symptoms are not uncommon in thyroid diseases and can be overlooked and misdiagnosed as acute exacerbation of asthma or COPD. Case report- A 58 years old female presented to emergency department with complaints of fever, shortness of breath from last 3-4 days for which she intubated in emergency department and shifted to ICU. Next day patient was absolutely fine and extubated and was planned to be shifted out surprisingly the same episode was repeated following which patient was intubated again and was found to be absolutely normal after 3-4 h and extubated again. The same episode was repeated next day as well. Eventually she was diagnosed to have cystic thyroid swelling. Immediate aspiration of the cyst done to relieve the symptoms and total thyroidectomy was done subsequently and patient was cured of the symptoms. Conclusion- Acute airway obstruction can occur in asymptomatic goitre patients. The anaesthetic management is crucial for airway till definitive surgery is done. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03179-x.