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Pericardial effusion in hypothyroidism: A case report.

Saurab Karki1, Rabindra Jang Rayamajhi2, Shreeja Shikhrakar3

  • 1Military Hospital, Sunsari, Nepal.

Annals of Medicine and Surgery (2012)
|November 26, 2021
PubMed
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Hypothyroidism can cause pericardial effusion, a buildup of fluid around the heart. Early diagnosis and thyroid hormone replacement therapy are crucial for resolving this potentially fatal complication.

Area of Science:

  • Endocrinology
  • Cardiology

Background:

  • Hypothyroidism is a common endocrine disorder with potential for multiorgan complications.
  • Pericardial effusion is a significant but less recognized complication of hypothyroidism.
  • Untreated pericardial effusion can lead to cardiac tamponade and hemodynamic instability.

Observation:

  • A 35-year-old male presented with symptoms including bilateral lower limb swelling, facial puffiness, cold intolerance, fatigue, and hoarseness.
  • Investigations revealed subclinical hypothyroidism (high TSH, low T3, positive anti-TPO) and hypertriglyceridemia.
  • Echocardiography showed minimal pericardial effusion with normal ventricular function.

Findings:

  • Thyroid hormone replacement therapy with thyroxine led to the resolution of the patient's symptoms and pericardial effusion.
Keywords:
Case reportHoarsenessHypothyroidismPericardial effusion

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  • Pericardial effusion in hypothyroidism is attributed to increased capillary permeability, altered albumin distribution, and reduced lymphatic drainage.
  • While uncommon in mild hypothyroidism, pericardial effusion can occur and may be fatal if overlooked.

    • Implications:

    • Early cardiac assessment is vital in patients with hypothyroidism, especially those with suggestive symptoms.
    • Prompt diagnosis and management of pericardial effusion in hypothyroidism are essential for preventing severe cardiac complications.
    • Thyroid replacement therapy is effective in reversing pericardial effusion associated with hypothyroidism.