Key result
Severe hypothyroidism can rarely present as acute cardiac tamponade, which is typically managed with thyroxine supplementation and occasionally pericardiocentesis.
Case Report (n=1)
Severe hypothyroidism should be considered in the differential diagnosis of cardiac tamponade, and its primary treatment is thyroxine supplementation rather than routine pericardiocentesis.
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Hypothyroidism merits consideration in tamponade differentials; extends sparse case reports but leaves open systematic study.
We report a patient who presented to our hospital with unusual symptoms of non-specific complaints and uncontrolled hypertension. Acute cardiac tamponade was suspected from cardiomegaly on routine chest x-ray and confirmed with an echocardiogram. Analysis of the pericardial fluid and other laboratory data ruled out all the common causes except for hypothyroidism as a cause of cardiac tamponade. Tamponade results from increased intrapericardial pressure caused by the accumulation of pericardial fluid. The rapidity of fluid accumulation is a greater factor in the development of tamponade than absolute volume of the effusion. Hypothyroidism is a well-known cause of pericardial effusion. However, tamponade rarely develops owing to a slow rate of accumulation of pericardial fluid. The treatment of hypothyroidic cardiac tamponade is different from other conditions. Thyroxine supplementation is all that is necessary. Rarely, pericardiocentesis is needed in a severely symptomatic patient.
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Butala et al. (2013) conducted a case report in Cardiac tamponade and severe hypothyroidism (n=1). Thyroxine supplementation was evaluated. Severe hypothyroidism can rarely present as acute cardiac tamponade, which is typically managed with thyroxine supplementation and occasionally pericardiocentesis.
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