Massive pericardial effusion and cardiac tamponade as the presentation form of hypothyroidism. Report of one case

We report et 43 years old female, admitted clue to fatigability, asthenia a nd diffuse abdominal pain. Oil admission, obesity, slowness of thinking, br adicardia, distention of jugular veins and ascites were observed oil physic al examination. Laboratory showed undetectable thyroid hormone levels, a ch est X ray showed bilateral pleural effusion and an enlarged heart. Art echo cardiography showed et massive pericardial effusion with collapse of the ri ght atrium and dilatation of both caval veins. A pericardial tap was perfor med, draining 350 ml. Thyroid hormone substitution was started and after 12 months of follow tip, the heart size decreased and a control echocardiogra m showed a minimal pericardial effusion.