TY - JOUR
T1 - Impending cardiac tamponade as a primary presentation of hypothyroidism
T2 - Case report and review of literature
AU - Karu, Andrew K.
AU - Khalife, Wissam I.
AU - Houser, Robert
AU - VanderWoude, John
PY - 2005
Y1 - 2005
N2 - 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.
AB - 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.
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U2 - 10.4158/EP.11.4.265
DO - 10.4158/EP.11.4.265
M3 - Article
C2 - 16006302
AN - SCOPUS:33644687994
SN - 1530-891X
VL - 11
SP - 265
EP - 271
JO - Endocrine Practice
JF - Endocrine Practice
IS - 4
ER -