{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:47:02Z","timestamp":1696063622071},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>We report on a young adult female presenting with altered mental status and chest pain. Timely review of her electronic medical record revealed a history of panhypopituitarism with poor medication adherence, although this was unknown at the time of her initial evaluation.<\/jats:p>\n          <jats:p>The patient required hormone replacement and significant fluid resuscitation, followed by definitive treatment with a pericardiocentesis. She was discharged home on hospital day 4, with normalization of her diminished left ventricular ejection fraction at her 1-month follow-up.<\/jats:p>\n          <jats:p>Although panhypopituitarism and cardiac tamponade are rare diagnoses, we highlight the management of severe hypothyroidism, the importance of early administration of hydrocortisone for panhypopituitarism, and the need for aggressive volume expansion to maintain preload in cardiac tamponade.<\/jats:p>","DOI":"10.1097\/pec.0000000000000589","type":"journal-article","created":{"date-parts":[[2016,1,19]],"date-time":"2016-01-19T19:41:56Z","timestamp":1453232516000},"page":"181-184","source":"Crossref","is-referenced-by-count":1,"title":["Chest Pain in the Setting of Altered Mental Status"],"prefix":"10.1097","volume":"33","author":[{"given":"Yuen Lie","family":"Tjoeng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Mickley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimball","family":"Prentiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib1-20230930","first-page":"493462","article-title":"Myxedema coma: a new look into an old crisis","volume":"2011","year":"2011","journal-title":"J Thyroid Res"},{"key":"bib2-20230930","first-page":"2485","article-title":"Myxedema coma: diagnosis and treatment","volume":"62","year":"2000","journal-title":"Am Fam Physician"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.ecl.2006.09.003","article-title":"Myxedema coma","volume":"35","year":"2006","journal-title":"Endocrinol Metab Clin North Am"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jemermed.2004.08.020","article-title":"Thyroid disease in the emergency department: a clinical and laboratory review","volume":"28","year":"2005","journal-title":"J Emerg Med"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.mcna.2012.01.015","article-title":"Thyroid emergencies","volume":"96","year":"2012","journal-title":"Med Clin North Am"},{"key":"bib6-20230930","doi-asserted-by":"crossref","first-page":"332","DOI":"10.7326\/0003-4819-18-3-332","article-title":"Myxedema heart: a pathological and therapeutic study","volume":"18","year":"1943","journal-title":"Ann Intern Med"},{"key":"bib7-20230930","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1161\/CIRCULATIONAHA.106.678326","article-title":"Cardiovascular involvement in general medical conditions: thyroid disease and the heart","volume":"116","year":"2007","journal-title":"Circulation"},{"key":"bib8-20230930","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1530\/EJE-12-0627","article-title":"Mechanisms in endocrinology: heart failure and thyroid dysfunction","volume":"167","year":"2012","journal-title":"Eur J Endocrinol"},{"key":"bib9-20230930","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1161\/CIRCULATIONAHA.107.737841","article-title":"Hemodynamic effects of volume expansion in patients with cardiac tamponade","volume":"117","year":"2008","journal-title":"Circulation"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S0735-1097(85)80309-0","article-title":"Alterations in intravascular volume affect the relation between right ventricular diastolic collapse and the hemodynamic severity of cardiac tamponade","volume":"6","year":"1985","journal-title":"J Am Coll Cardiol"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201703000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:11:11Z","timestamp":1696061471000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201703000-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000000589","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}