A case report on a rare manifestation of hypothyroid patient; cardiac tamponade
Here presented is a patient admitted to our hospital with cardiac tamponade, a rare manifestation of hypothyroidism. Her presentation was non-specific symptoms like easy fatigability, poor appetite and left anterior chest discomfort of 01 year duration. She was evaluated in our hospital before 05 months and was started on anti-tuberculous management. But despite the anti-tuberculous treatment her condition worsened and upon her current admission she has 01 episode of syncope. She was hypotensive and depressed. Pericardial fluid analysis showed a cell count of 200 cells per microliter but mycobacterium tuberculosis was not detected on AFB stain. Cytology of the pericardial fluid revealed just reactive effusion. Tamponade results from increased intrapericardial pressure caused by the accumulation of pericardial fluid. The rapidity of fluid accumulation is a greater factor in the development of tamponade than absolute volume of the effusion. Hypothyroidism is a well-known cause of pericardial effusion. However, tamponade rarely develops owing to a slow rate of accumulation of pericardial fluid. The treatment of hypothyroidic cardiac tamponade is different from other conditions. Thyroxine supplementation is all that is necessary. Rarely, pericardiocentesis is needed in a severely symptomatic patient. Our patient improved with levothyroxine treatment.
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