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VOLUME 26 , ISSUE 5 ( May, 2022 ) > List of Articles


Primary Hypothyroidism Presenting as Cardiac Tamponade

Prasan K Panda, Shridhar Pattar, Budha O Singh, Taranjeet Cheema

Keywords : Hypothyroidism, Pericardial effusion, Pericardiocentesis, Thyroxine replacement

Citation Information : Panda PK, Pattar S, Singh BO, Cheema T. Primary Hypothyroidism Presenting as Cardiac Tamponade. Indian J Crit Care Med 2022; 26 (5):655-657.

DOI: 10.5005/jp-journals-10071-24210

License: CC BY-NC 4.0

Published Online: 20-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Hypothyroidism is commonly associated with pericardial effusion, but it can be rarely complicated by cardiac tamponade. We report a case series of two patients who presented with shortness of breath and distension of the abdomen, progressing to generalized edema. Each of them was found to have cardiac tamponade at presentation and eventually diagnosed with hypothyroidism. They were managed by urgent pericardiocentesis followed by intermittent drainage of the collected pericardial effusion along with thyroxine replacement to which they responded. The presence of cardiac tamponade with bradycardia should raise a suspicion of a hypothyroid etiology. Early diagnosis and treatment of hypothyroidism are essential to prevent such complications.

  1. Chen YJ, Hou SK, How CK, Chern CH, Lo HC, Yen DH, et al. Diagnosis of unrecognized primary overt hypothyroidism in the ED. Am J Emerg Med 2010;28(8):866–870. DOI: 10.1016/j.ajem.2009.04.024.
  2. Velibey Y, Calik AN, Satilmis S, lliksu H. First and only manifestation of Hashimoto's disease: pericardial tamponade. Turk Kardiyol Dern Ars 2012;40(5):454–457. DOI: 10.5505/tkda.2012.42078.
  3. Butala A, Chaudhari S, Sacerdote A. Cardiac tamponade as a presenting manifestation of severe hypothyroidism. BMJ Case Rep 2013;2013:bcr2012005281. DOI: 10.1136/bcr-12-2011-5281.
  4. Jensen JK, Poulsen SH, Mølgaard H. Cardiac tamponade: a clinical challenge. 2017;15(17):107–113. http://www.irbis- =2&I21DBN=UJRN&P21DBN=UJRN&IMAGE_FILE_DOWNLOAD=1&Image_file_name=PDF/Konkp_2017_4_10.pdf.
  5. Manhas Y, Gokhale A. Lung collapse secondary to massive pericardial effusion in adults: two case reports. Indian J Crit Care Med 2018;22(3):191–194. DOI: 10.4103/ijccm.IJCCM_391_17.
  6. Kulkarni S, Karnad D. Unusual presentation of pericardial effusion. Indian J Crit Care Med 2012;16(4):219–221. DOI: 10.4103/0972-5229.106507.
  7. Patil VC, Patil HV, Agrawal V, Patil S. Cardiac tamponade in a patient with primary hypothyroidism. Indian J Endocrinol Metab 2011;15(Suppl 2):S144–S146. DOI: 10.4103/2230-8210.83358.
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