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Case Reports
. 2023 Oct 18:46:62.
doi: 10.11604/pamj.2023.46.62.41687. eCollection 2023.

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

Muhammadnur Rachim Enoch  1 , Muhammad Irfan  1 , Rachmad Budianto  1 , Achmad Hardin  1
Affiliations
Case Reports

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

Muhammadnur Rachim Enoch et al. Pan Afr Med J. .

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.

Keywords: Cardiac tamponade; Hashimoto’s thyroiditis; case report; hypothyroidism.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
the ECG showing normal sinus rhythm with low voltage, right axis deviation (RAD), and incomplete right bundle branch block (RBBB)
Figure 2
Figure 2
chest radiogram showing cardiomegaly with globular enlargement of the cardiac silhouette with “water bottle” configuration
Figure 3
Figure 3
a two-dimensional transthoracic echocardiography reveals a significant pericardial effusion surrounding the heart; the red arrow indicates the effusion, while the blue arrow indicates right ventricular (RV) collapse; (LV: left ventricular, LA: left atrium, RA: right atrium)
Figure 4
Figure 4
the follow-up echocardiography after pericardiocentesis
See this image and copyright information in PMC

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