Cardiac tamponade in Hashimoto's disease.
International Journal of Cardiology (Impact Factor: 5.51). 09/2006; 111(3):470-1. DOI:10.1016/j.ijcard.2005.07.027
ABSTRACT Myxedematous pericardial effusions, occurring in about one-third of patients with hypothyroidism, usually do not cause symptoms and regress slowly with hormonal treatment. We report a cardiac tamponade inaugural of a Hashimoto's disease.
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ABSTRACT: To examine whether the size of the effusion, the presence of tamponade, and inflammatory signs are useful in determining the causes of moderate or severe pericardial effusions. All echocardiograms performed at a general hospital between January 1990 and April 1996 were screened for pericardial effusion. Patients with moderate (echo-free space of 10 to 20 mm during diastole) or severe (echo-free space >20 mm) effusions were studied. We identified 322 patients (166 [52%] men, mean [+/- SD] age 56 +/- 17 years [range 15 to 88 years]), 132 (41%) with moderate and 190 (59%) with severe pericardial effusion. The most frequent etiologic diagnoses were acute idiopathic pericarditis (n = 66 [20%]), iatrogenic effusions (n = 50 [16%]), cancer (n = 43 [13%]), and chronic idiopathic pericardial effusion (n = 29 [9%]). In 192 (60%) of the patients, the cause of the effusion was a known medical condition. In the 130 other patients, inflammatory signs were associated with acute idiopathic pericarditis (likelihood ratio = 5. 4, P < 0.001), severe effusions without inflammatory signs or tamponade were associated with chronic idiopathic pericardial effusion (likelihood ratio = 20, P < 0.001), and tamponade without inflammatory signs was associated with malignant effusions (likelihood ratio = 2.9, P < 0.01). In many patients, pericardial effusions are due to a known underlying disease or condition. In patients without underlying diseases, inflammatory signs, the size of effusion, and the presence or absence of cardiac tamponade can be helpful in establishing cause.The American Journal of Medicine 08/2000; 109(2):95-101. · 4.77 Impact Factor
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ABSTRACT: Massive pericardial effusions secondary to hypothyroidism are rarely seen in the emergency department (ED). The case of a patient presenting with a relatively asymptomatic massive pericardial effusion due to hypothyroidism is described. The patient had a history of laryngeal carcinoma post-total laryngectomy and adjuvant radiotherapy 12 years previous. Although underlying malignancy was in the differential diagnosis, hypothyroidism was diagnosed through a detailed history and physical examination, thereby avoiding the need for pericardiocentesis. Thyroid replacement alone is sufficient for resolution of these effusions, although it may take many months. Pericardiocentesis is indicated only if cardiac tamponade develops. This rare but significant condition should be considered, especially when it occurs after acute cold exposure.Journal of Emergency Medicine 05/2005; 28(3):293-6. · 1.33 Impact Factor
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