Hydropericardium in hypothyroidism. Features of the clinic, diagnosis and treatment
https://doi.org/10.14341/ket12778
Abstract
Thyroid hormone deficiency negatively affects the state of the cardiovascular system, causing the formation of a «myxedematous heart». The frequency and clinical features of primary hypothyroidism in 84 patients discharged from the endocrinology department of the RCH in 2017-2022 were retrospectively analyzed. Pericardial effusion was registered in 9 people (10.7%). Massive effusion with separation of pericardial leaflets from 30 to 50 mm and the threat of tamponade was in 4 out of 9 patients. Even with a large volume of pericardial effusion, classic symptoms such as shortness of breath, orthopnea, chest pain, and a feeling of fullness were absent or poorly expressed. Differential diagnosis with diseases accompanied by accumulation of fluid in the pericardial cavity was required. Indicators of thyroid status made it possible to associate the hydropericardium with decompensation or hypothyroidism for the first time. Thyroid hormone replacement therapy led to the disappearance of hypothyroidism symptoms and a decrease in the hydropericardium. With a high risk of tamponade in 3 patients, therapy was supplemented with pericardiocentesis. A clinical observation of successful treatment with thyroid hormones in combination with pericardiocentesis of severe newly diagnosed hypothyroidism against the background of autoimmune thyroiditis with massive pericardial effusion is presented.
About the Authors
I. A. Bondar
Novosibirsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Irina A. Bondar, MD, PhD, Professor
52 Krasniy prospect, Novosibirsk, 630091
AuthorID: 155448
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи
L. I. Chesnochenko
Novosibirsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ludmila I. Chesnochenko, MD, PhD
Novosibirsk
AuthorID: 473644
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи
I. P. Krasnopevtseva
Novosibirsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Irina P. Krasnopevtseva, MD, PhD
Novosibirsk
AuthorID: 1047129
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи
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Supplementary files
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1. Figure 1: Patient's electrocardiogram. | |
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2. Figure 2. Cardiac ultrasound. Hydropericardium at the apex. | |
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3. Figure 3. Cardiac ultrasound. Hydropericardium in the posterior parts of the heart. | |
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4. Figure 4. Cardiac ultrasound. Hydropericardium behind the right side of the heart. | |
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5. Figure 5. Radiological CT scan of the chest. | |
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6. Figure 6 (a, b). Review radiographs of the chest organs in dynamics. | |
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For citations:
Bondar I.A., Chesnochenko L.I., Krasnopevtseva I.P. Hydropericardium in hypothyroidism. Features of the clinic, diagnosis and treatment. Clinical and experimental thyroidology. 2023;19(3):4-13. (In Russ.) https://doi.org/10.14341/ket12778
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