PMID- 33685911
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20240331
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 14
IP  - 3
DP  - 2021 Mar 8
TI  - Graves' disease inducing a massive cardiac tamponade.
LID - 10.1136/bcr-2020-239772 [doi]
LID - e239772
AB  - A 23-year-old woman was diagnosed with Graves' disease 5 months ago with 
      decompensated thyroid function, for which she is taking thiamazole and 
      propranolol. She developed progressive respiratory dyspnoea [New York Heart 
      Association (NYHA) class III] and frequent palpitations. On emergency admission, 
      the patient was tachypnoeic, hypotensive (77/54 mm Hg) and tachycardic (120 beats 
      per minute), with an oxygen saturation of 94%. She also presented with cold, 
      swollen and shaky extremities, with extended capillary filling time, and a 
      significant reduction in heart sounds. Echocardiogram showed massive pericardial 
      effusion compatible with cardiac tamponade. Pericardiocentesis was performed, 
      with a drainage of 1420 mL serosanguinolent fluid, with prompt haemodynamic 
      recovery. Analysis of the pericardial fluid showed exudates. A diagnosis of 
      pericardial effusion secondary to Graves' disease was determined and 
      corticotherapy, lithium carbonate, cholestyramine and phenobarbital were 
      prescribed. An oral iodine-131 was performed and the patient showed reasonable 
      control of the clinical manifestations of hyperthyroidism. After 3 months, the 
      patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a 
      significant reduction in pericardial effusion.
CI  - (c) BMJ Publishing Group Limited 2021. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Fonseca, Elisabeth Martinez
AU  - Fonseca EM
AD  - Internal Medicine, Roberto Santos General Hospital, Salvador, Bahia, Brazil.
FAU - Schonhofen, Igor
AU  - Schonhofen I
AD  - Internal Medicine, Roberto Santos General Hospital, Salvador, Bahia, Brazil.
FAU - Toralles, Maria Pereira
AU  - Toralles MP
AD  - DNA Laboratory, Salvador, Brazil.
FAU - de Carvalho, Jozelio Freire
AU  - de Carvalho JF
AUID- ORCID: 0000-0002-7957-0844
AD  - Institute for Helath Sciences, Federal University of Bahia, Salvador, Brazil 
      jotafc@gmail.com.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210308
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 554Z48XN5E (Methimazole)
SB  - IM
MH  - Adult
MH  - *Cardiac Tamponade/etiology/surgery
MH  - Female
MH  - *Graves Disease/complications/diagnosis/drug therapy
MH  - Humans
MH  - Methimazole/therapeutic use
MH  - *Pericardial Effusion/surgery
MH  - Pericardiocentesis
MH  - Young Adult
PMC - PMC7942269
OTO - NOTNLM
OT  - pericardial disease
OT  - thyroid disease
COIS- Competing interests: None declared.
EDAT- 2021/03/10 06:00
MHDA- 2021/05/15 06:00
PMCR- 2023/03/08
CRDT- 2021/03/09 06:01
PHST- 2021/03/09 06:01 [entrez]
PHST- 2021/03/10 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2023/03/08 00:00 [pmc-release]
AID - 14/3/e239772 [pii]
AID - bcr-2020-239772 [pii]
AID - 10.1136/bcr-2020-239772 [doi]
PST - epublish
SO  - BMJ Case Rep. 2021 Mar 8;14(3):e239772. doi: 10.1136/bcr-2020-239772.