title: Cardiac tamponade as a presenting manifestation of Sheehan syndrome.
abstract: We report a 38-year-old Syrian woman who presented with progressive breathlessness, hypotension and circulatory collapse. Echocardiogram revealed a large pericardial effusion with evidence of cardiac tamponade. There was a history of secondary amenorrhoea, loss of axillary and pubic hair following childbirth at 28 years of age. Investigations revealed low levels of gonadotrophins, oestrogen, prolactin and thyrotrophin but normal levels of basal and post-synacthen (ACTH) cortisol. An MRI of the sella showed atrophic changes of the pituitary. She was treated with intravenous fluids, dopamine infusion, intravenous hydrocortisone and thyroxine replacement. The clinical suspicion of Sheehan syndrome facilitated early administration of corticosteroids, adequate thyroxine replacement and rapid resolution of pericardial effusion.
authors.affiliation: Department of Medicine, Al-Sabah Hospital, Ministry of Health, Kuwait, P.O. Box 29866, Safat 13159, Kuwait.
authors.forename: Varkey
authors.initials: V
authors.lastname: Alexander
authors.forename: Arijit
authors.initials: A
authors.lastname: Chattopadhyay
authors.forename: Khalid
authors.initials: K
authors.lastname: Yasin
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Kurian
mesh_terms: D000328:Adult; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D012769:Shock / Q000209:etiology