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Case Reports in Cardiology
Volume 2015, Article ID 310350, 5 pages
http://dx.doi.org/10.1155/2015/310350
Case Report

Early Cardiac Tamponade in a Patient with Postsurgical Hypothyroidism

1Division of Cardiology, Saint Luke’s University Health Network, Bethlehem, PA 18015, USA
2Division of Hematology and Oncology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
3Division of Cardiology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA

Received 28 May 2015; Accepted 21 July 2015

Academic Editor: Gerard Devlin

Copyright © 2015 Archana Sinha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pericardial effusion is a common cardiac manifestation of hypothyroidism, but effusion resulting in cardiac tamponade is extremely rare. We present a case of a 56-year-old African American woman with slurred speech and altered mental status that was initially suspected to have stroke. Her chest X-ray revealed cardiomegaly and subsequent echocardiogram showed a large pericardial effusion with echocardiographic evidence of cardiac tamponade. Clinically, patient did not have pulsus paradoxus or hypotension. Further questioning revealed a history of total surgical thyroidectomy and noncompliance with thyroid replacement therapy. Pericardiocentesis was performed promptly and thyroxine replacement therapy was started. Thereafter, her mental status improved significantly. The management of pericardial effusion associated with hypothyroidism varies depending on size of effusion and hemodynamic stability of the patient. The management strategy ranges from conservative management with close monitoring and thyroxine replacement to pericardiocentesis or creation of a pericardial window.