Abstract
Abstract: Introduction: Hypothyroidism is a common endocrine disorder with multiorgan involvement. Pericardial effusion usually occurs in longstanding severe hypothyroidism. Clinical description: 68-year-old female patient with a 3-week history of dyspnea, dysphonia, fatigue, and lower limb swelling. Initial laboratory workup reported elevated thyroid stimulating hormone (TSH). Chest x-ray showed cardiomegaly. Echocardiography revealed pericardial effusion and diastolic collapse of the right ventricle. Percutaneous pericardial drainage was performed, and levothyroxine initiated. Five days later, the patient was discharged with resolution of symptoms and no residual effusion. Discussion: Timely detection of cardiovascular complications such as pericardial effusion can prevent further hemodynamic compromise and death.
References
- Chahine, J., Klein, A.L., Ala, C.K., Gentry, J.L., Pantalone KM. Pericardial diseases in patients with hypothyroidism. Heart. 2019, Jul.; 105(13) :1027-1033. DOI: 10.1136/heartjnl-2018-314528. DOI: https://doi.org/10.1136/heartjnl-2018-314528
- Klein, I., Danzi, S. Thyroid Disease and the Heart. Curr Probl Cardiol. 2015, Feb.; 41(2): 65–92. DOI: 10.1016/j.cpcardiol.2015.04.002 DOI: https://doi.org/10.1016/j.cpcardiol.2015.04.002
- Adler, Y., Charron, P., Imazio, M., Badano, L., Barón-Esquivias, G., Bogaert, J., et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases : The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015, Nov.; 36(42): 2921–2964. https://doi.org/10.1093/eurheartj/ehv318 DOI: https://doi.org/10.1093/eurheartj/ehv318
- Wang, J.L., Hsieh, M.J., Lee, C.H., Chen, C.C., Hsieh, I.C., Lin, J.-D., et al. Hypothyroid cardiac tamponade: clinical features, electrocardiography, pericardial fluid and management. Am J Med Sci. 2010, Oct.; 340(4): 276-281. DOI: 10.1097/MAJ.0b013e3181e664c6 DOI: https://doi.org/10.1097/MAJ.0b013e3181e664c6
- Butala, A., Chaudhari, S., Sacerdote, A. Cardiac tamponade as a presenting manifestation of severe hypothyroidism. BMJ Case Rep. 2013, Feb.; bcr2012005281. DOI: 10.1136/bcr-12-2011-5281 DOI: https://doi.org/10.1136/bcr-12-2011-5281
- Karu, A.K., Khalife, W.I., Houser, R., VanderWoude, J. Impending cardiac tamponade as a primary presentation of hypothyroidism: Case report and review of literature. Endocr Pract. 2005, July; 11(4): 265–271. DOI: 10.4158/EP.11.4.265 DOI: https://doi.org/10.4158/EP.11.4.265
