A Case of Profound Hypothyroidism Presenting with Hypertensive Emergency and Large Amount of Pericardial Effusion

Figures

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  Figure 1.. Non-contrast brain computed tomography showing intracranial hemorrhage on the right basal ganglia, right thalamus, and right periventricular white matter.

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  Figure 2.. (A) Electrocardiogram showing normal sinus rhythm. (B) Chest X-ray showing the “water bottle” sign, indicating a large cardiomegaly.

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  Figure 3.. Pre-pericardiocentesis echocardiographic findings. Transthoracic echocardiography showed a circumferential large amount of pericardial effusion (maximal thickness, about 30 mm at the posterior side of the ventricular wall) with slight compression of the right atrium and right ventricle. Left ventricular systolic function was preserved. (A) A large amount of pericardial effusion was observed on the parasternal long-axis view and parasternal short-axis views. (B) A large amount of pericardial effusion was also observed in various apical views.

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  Figure 4.. Post-pericardiocentesis echocardiographic findings. (A) Pericardial effusion was not observed on the parasternal long-axis view or parasternal short-axis views. Definite concentric left ventricular hypertrophy was detected on the parasternal long-axis view. (B) Pericardial effusion was not observed on various apical views. (C) The mitral valve inflow velocity in terms of E and A velocity and mitral annulus tissue Doppler velocity as e’ and a’ velocities were clearly detected after pericardiocentesis.