Impending cardiac tamponade as a primary presentation of hypothyroidism: Case report and review of literature

Andrew K. Karu, Wissam I. Khalife, Robert Houser, John VanderWoude

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Objective: To describe a patient who presented with pericardial effusion and impending cardiac tamponade attributable to hypothyroidism. Methods: We present clinical, laboratory, and imaging data for the current patient and review the literature relative to clinical presentation, prevalence, pathophysiology, diagnosis, and treatment of pericardial effusion and tamponade. Results: In comparison with previously reported cases, our current case is rare, in that our patient, a 51-year-old woman, presented with impending cardiac tamponade as an initial manifestation of hypothyroidism. Echocardiography demonstrated a large pericardial effusion and diastolic right atrial collapse. A pericardial window procedure was performed, and 1,500 mL of fluid was removed. Levothyroxine therapy was initiated. One month later, recurrent pericardial effusion necessitated a similar intervention, after which the patient recovered and was managed by outpatient follow-up and monitoring of the thyrotropin level. Conclusion: From our review of the literature, we conclude that impending cardiac tamponade is a rare initial manifestation of hypothyroidism. A high index of suspicion must be maintained for timely diagnosis of pericardial tamponade followed by prompt intervention. Recurrent pericardial effusions are common, necessitating close follow-up. Treatment of the hypothyroidism with levothyroxine is imperative.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalEndocrine Practice
Issue number4
StatePublished - 2005
Externally publishedYes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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