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Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
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Published on: April 18, 2025

Cardiac tamponade as a presenting manifestation of Sheehan syndrome

Varkey Alexander1, Arijit Chattopadhyay, Khalid Yasin

  • 1Department of Medicine, Al-Sabah Hospital, Ministry of Health, Kuwait, P.O. Box 29866, Safat 13159, Kuwait.

The National Medical Journal of India
|March 10, 2009
PubMed

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.

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