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ARTICLE |

Hypothyroid Cardiac Tamponade

Antonis S. Manolis, MD; Philip Varriale, MD; Roman M. Ostrowski, MD
Arch Intern Med. 1987;147(6):1167-1169. doi:10.1001/archinte.1987.00370060163027.
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Pericardial effusion, a common cardiac manifestation of myxedema,1,2 is rarely associated with cardiac tamponade; to our knowledge, only 19 reports of this phenomenon appear in the English literature.3-7 In all reported cases, identification of tamponade was largely derived from clinical and echocardiographic examination, and available hemodynamic data were described in only one report. In this presentation, the hemodynamic measurements relevant to the diagnosis of cardiac tamponade and the dynamic physiologic alterations subsequent to pericardiocentesis are more fully elucidated by reference to the recently described hemodynamic concept of pericardial constraint.8,9

REPORT OF A CASE  A 63-year-old obese man was admitted to the coronary care unit because of increasing dyspnea and swollen legs over the preceding several weeks. Digitalis and furosemide had been prescribed for presumed heart failure. At the time of hospital admission, the patient had overt tachypnea, respiratory distress, and cyanosis. Blood pressure was 100/60 mm Hg,

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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