Cardiac tamponade as the initial manifestation of severe hypothyroidism A case report英文文献资料.docVIP

World Journal of Cardiovascular Diseases, 2012, 2, 321-325 WJCD /10.4236/wjcd.2012.24051 Published Online October 2012 (http://www.SciRP.org/journal/wjcd/) Cardiac tamponade as the initial manifestation of severe hypothyroidism: A case report Ronny Cohen , Pablo Loarte , Simona Opris , Brooks Mirrer 1,2* 2,3 2 1,2 1 2 3 NYU School of Medicine, New York, USA Division of Cardiology, Woodhull Medical Center, New York, USA Division of Nephrology and Hypertension, Brookdale University Hospital and Medical Center, New York, USA Email: ronny.cohen@ * Received 11 May 2012; revised 14 June 2012; accepted 23 June 2012 ABSTRACT incidence of pericardial effusion secondary to hypothy- roidism varies in different studies from 30% to 80% [2]. Cardiac tamponade as a complication of hypothyroidism is very rare [3]. Until 1992, there were less than 30 cases described and even more recently there are only few cases found in the world literature. This low incidence is most likely due to slow accumulation of fluid and grad- ual pericardial distention [4]. Hypothyroidism is cha- racterized by low metabolic demands and therefore, de- spite a depressed cardiac contractility and cardiac out- put, cardiac function remains sufficient to sustain the workload imposed on the heart. Another feature that dis- tinguishes cardiac tamponade caused by hypothyroidism from the other causes of tamponade is the absence of sinus tachycardia as a mechanism to maintain cardiac output [5]. We report a case of cardiac tamponade as a pre- senting manifestation of hypothyroidism. Background: Hypothyroidism is a commonly seen con- dition. The presence of pericardial effusion with car- diac tamponade as initial manifestation of this endoc- rinological condition is very unusual. Objectives: In hypothyroidism pericardial fluid accumu