Cardiac tamponade as initial presentation of primary hypothyroidism

Abstract

Introduction: Pericardial effusion is a rare complication of hypothyroidism; its progression to tamponade is frequently underdiagnosed due to low clinical suspicion, causing delays in treatment and fatal complications. The only possible etiology was manifest hypothyroidism with myxedematous manifestations, with ultrasound suggestive of chronic autoimmune thyroiditis and positive antithyroid antibodies, with clinical stabilization after the pericardial window and further improvement with thyroid hormone replacement.
Objective: Identify patients with electrocardiographic signs of tamponade, such as electrical alternation, low voltage, added to bradycardia, and a chest X-ray with cardiomegaly, which allows us to think of hypothyroidism as an underlying etiology.
Case presentation: A 41-year-old male patient was admitted due to edematous syndrome and dyspnea, with clinical and laboratory findings suggestive of massive pericardial effusion and signs of cardiac tamponade. He was treated with pericardial drainage and levothyroxine.
Discussion: The causes of dyspnea in the patient who visits the emergency room are innumerable. The anamnesis and the semiological findings during the clinical evaluation are the starting point for its study. . Concerning hypothyroidism and dyspnea of cardiac origin, this has support based on which various physiopathological aspects converge.
Conclusions: The identification of individuals with risk factors for PH, its diagnosis, and treatments that have a positive impact on the reduction of symptoms and complications.