Cardiac Tamponade: Rare presentation of Hypothyroidism

Abstract

Hypothyroidism is a common endocrine disorder among the middle aged females. Pericardial effusion presenting in a hypothyroid patient is not uncommon, whereas a cardiac tamponade reporting in a patient with hypothyroidism is a rare entity. Here with we present a case of hypothyroidism presenting with a cardiac tamponade. A 60 year old known hypothyroid female on irregular treatment presented with features suggestive of congestive cardiac failure. Her vitals were as follows, pulse rate: 65/min; blood pressure: 90/60 mm Hg; respiratory rate: 18/min; the heart sounds were found to be distant and muffled. ECG and echocardiogram confirmed that the patient had a massive pericardial effusion. Under the guidance of echocardiography about 700 ml of pericardial fluid was aspirated through apical approach. The aspirated fluid was exudative and sterile. The patient improved symptomatically on pericardial aspiration, started on thyroxine 200 µg/day and is on regular follow-up.

Cardiac Tamponade in a Patient With Hypothyroidism: A Case Report

“…(11,16) In some case reports, initial dose is varied, starting from 25mcg/day to 400 mcg/day, depending on thyroid function examination results and other presenting comorbidities. (17)(18)(19)(20)…”