Cardiac tamponade as a presentation of primary adrenal insufficiency

Cardiac tamponade is an important and severe consequence of pericardial effusion. Patients with haemodynamically significant pericardial effusions present with signs and symptoms relating to the degree of their impaired cardiac function. Although autoimmune disease is a recognised cause of pericardial effusion, cardiac tamponade as a clinical presentation of primary adrenal insufficiency (PAI) is infrequently reported. We present a case of a woman, in her early 50s, who was admitted to the coronary care unit with cardiac tamponade caused by an acute adrenal crisis from unrecognised PAI. We hope to raise clinicians' awareness of PAI as a rare but important cause of cardiac tamponade.