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Hypothyroidism presenting with recurrent pericardial tamponade
Stephen Arthur1, Gailash Beeharry-Panray, Jonathan Fitzgerald
1Glenfield General Hospital, c/o Dr Loke, Groby Road, Leicester LE3 9QP, UK.
BMJ Case Reports
|December 2, 2011
Summary
Hypothyroidism can cause pericardial tamponade, a serious heart condition. Prompt diagnosis and aggressive thyroid hormone replacement therapy, including liothyronine (T3), are crucial for managing recurrent effusions.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Pericardial effusion is fluid accumulation around the heart.
- Cardiac tamponade is a life-threatening condition caused by pericardial effusion.
- Hypothyroidism is a common endocrine disorder with various systemic manifestations.
Purpose of the Study:
- To report a case of pericardial tamponade secondary to hypothyroidism.
- To highlight the diagnostic challenges and management strategies for this rare presentation.
Main Methods:
- Case presentation of a 66-year-old man with chest pain.
- Diagnostic workup including computed tomography and echocardiography.
- Laboratory tests revealing profound hypothyroidism.
- Therapeutic interventions involving fluid drainage and thyroid hormone replacement.
Main Results:
- Computed tomography excluded aortic dissection; echocardiography confirmed pericardial effusion and tamponade.
- Thyroid function tests indicated severe hypothyroidism.
- Initial levothyroxine (T4) therapy led to effusion re-accumulation.
- Aggressive liothyronine (T3) therapy resulted in no further effusion recurrence.
Conclusions:
- Hypothyroidism should be considered in unexplained pericardial effusions.
- Vigilance for effusion re-accumulation is necessary.
- Liothyronine (T3) therapy may be effective for refractory cases.
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