title: Cardiac tamponade as a presenting manifestation of severe hypothyroidism.
abstract: 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.
authors: Department of Medicine,  Woodhull Medical Center, Brooklyn, New York,  USA.
authors: Ashvin
authors: A
authors: Butala
authors: Shilpa
authors: S
authors: Chaudhari
authors: Alan
authors: A
authors: Sacerdote
mesh_terms: D000328:Adult; D002305:Cardiac Tamponade / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D010490:Pericardial Effusion / Q000209:etiology; D020519:Pericardiocentesis
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