Massive pericardial effusion resulted from hypothyroidism: a case report

Abstract Hypothyroidism is an endocrine disorder characterized by high level of thyroid stimulating hormone and normal or low level of free thyroxine 4 (FT4). Mild pericardial effusion may complicate hypothyroidism but massive pericardial effusion or cardiac tamponade is quite uncommon. A 40 year old female presented to our emergency unit complaining of worsening shortness of breath for one week, transthoracic echocardiography revealed massive pericardial effusion. Laboratory examination showed elevated thyroid stimulating hormone (TSH), and decreased thyroxine (T4) and triiodothyronine (T3) levels. The patient diagnosed as a case of primary hypothyroidism complicated by pericardial effusion and treated with L-thyroxine replacement therapy. Possibility of hypothyroidism should be put in mind when assessing cases of pericardial effusion, even if there were no overt features of the disease, especially when other commoner causes of pericardial effusion were excluded.