Abstract：
Large pericardial effusions with associated cardiac tamponade are a rare manifestation of hypothyroidism. We present the case of a 63-year-old female with chronic heart failure and newly diagnosed hypothyroidism, who presented to her primary care physician complaining of progressively worsening dyspnea. Chest radiography showed cardiomegaly and transthoracic echocardiography (TTE) revealed a large pericardial effusion with tamponade physiology. An emergent pericardial window was performed, resulting in an improvement in left ventricular systolic function. Pericardial tissue biopsy was normal. Thyroid function tests were consistent with severe primary hypothyroidism. After inpatient treatment with intravenous levothyroxine and interval resolution of symptoms without recurrence of effusion, the patient was discharged home on oral levothyroxine therapy. Close follow up with surveillance echocardiography was planned. While metabolic disorders are seldom thought of as an etiology, it is imperative for clinicians to recognize hypothyroidism as a cause of the pericardial effusion. It is one of the few reversible causes and delay in treatment can result in fatal sequelae.
摘要：
大量心包积液伴相关心包填塞是甲状腺功能减退症的罕见表现。我们介绍了一名63岁的女性，患有慢性心力衰竭和新诊断的甲状腺功能减退，她向她的初级保健医生提出抱怨呼吸困难逐渐恶化。胸部X线检查显示心脏肥大，经胸超声心动图（TTE）显示有大量心包积液并伴有生理填塞。进行了紧急心包窗，导致左心室收缩功能的改善。心包组织活检正常。甲状腺功能检查与重度原发性甲状腺功能减退症一致。经静脉注射左甲状腺素住院治疗后，症状间期消退，无积液复发，患者接受口服左甲状腺素治疗后出院回家.计划在超声心动图监测下进行密切随访。虽然代谢紊乱很少被认为是病因，临床医生必须认识到甲状腺功能减退是心包积液的原因。它是少数可逆的原因之一，延迟治疗可导致致命的后遗症。
