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Myxedema coma is a severe form of hypothyroidism characterized by a range of critical signs and symptoms that reflect a significant decrease in thyroid hormone levels. Common clinical manifestations include bradycardia, which is a slowing of the heart rate, as the metabolic rate is significantly lower in this condition. Additionally, hyponatremia, indicated by sodium levels less than 135 mEq/L, is also frequently observed due to the decreased ability to excrete water and subsequent dilution of sodium in the blood. Hypothermia is another hallmark of myxedema coma; patients often present with a dangerously low body temperature, highlighting the metabolic slowdown.

Fever, on the other hand, is not typically associated with myxedema coma. In fact, patients often present with a decreased temperature. The absence of fever helps distinguish myxedema coma from other conditions that may cause altered mental status or metabolic imbalances, as fever often indicates an infectious or inflammatory process rather than a metabolic crisis resulting from hypothyroidism. Therefore, the correct understanding of myxedema coma indicates that fever is not a sign or symptom commonly present in this condition, making it the exception among the choices provided.