Hashimoto’s thyroiditis presenting with cardiac tamponade: a case report

Muhammadnur Rachim Enoch, Muhammad Irfan, Rachmad Budianto, Achmad Hardin
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Abstract

Cardiac tamponade as the initial manifestation of Hashimoto's thyroiditis is an exceedingly uncommon occurrence. We present the case of a 36-year-old female who was admitted due to acute respiratory distress. A cardiac ultrasound revealed a severe pericardial effusion with tamponade signs. Subsequently, percutaneous pericardiocentesis was performed, resulting in a swift clinical improvement. Laboratory examinations confirmed severe hypothyroidism associated with Hashimoto's disease. Despite undergoing hormone replacement therapy, histological analysis of the pericardium revealed a chronic inflammation process. A follow-up cardiac ultrasound conducted six months later indicated the presence of a well-tolerated chronic pericardial effusion. In conclusion, clinicians should consider hypothyroidism as a potential cause when cardiac tamponade is observed, particularly in the absence of tachycardia. The prognosis is generally favorable with hormone replacement therapy, but regular ultrasound monitoring should be maintained until the patient achieves a euthyroid state.
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桥本甲状腺炎表现为心脏填塞1例
摘要以心脏填塞作为桥本甲状腺炎的初始表现是极为罕见的。我们提出的情况下,36岁的女性谁是入院由于急性呼吸窘迫。心脏超音波显示严重的心包积液及心包填塞征。随后行经皮心包穿刺术,临床迅速好转。实验室检查证实与桥本氏病相关的严重甲状腺功能减退。尽管接受激素替代治疗,心包的组织学分析显示慢性炎症过程。六个月后进行的心脏超声随访显示存在耐受性良好的慢性心包积液。总之,当观察到心包填塞时,特别是在没有心动过速的情况下,临床医生应考虑甲状腺功能减退是一个潜在的原因。激素替代治疗的预后通常是良好的,但应保持定期超声监测,直到患者达到甲状腺功能正常状态。
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