{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:36:35Z","timestamp":1781771795971,"version":"3.54.5"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,26]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Cardiac tamponade is an important and severe consequence of pericardial effusion. Patients with haemodynamically significant pericardial effusions present with signs and symptoms relating to the degree of their impaired cardiac function. Although autoimmune disease is a recognised cause of pericardial effusion, cardiac tamponade as a clinical presentation of primary adrenal insufficiency (PAI) is infrequently reported. We present a case of a woman, in her early 50s, who was admitted to the coronary care unit with cardiac tamponade caused by an acute adrenal crisis from unrecognised PAI. We hope to raise clinicians\u2019 awareness of PAI as a rare but important cause of cardiac tamponade.<\/jats:p>","DOI":"10.1136\/bcr-2021-248099","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T11:14:18Z","timestamp":1646392458000},"page":"e248099","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Cardiac tamponade as a presentation of primary adrenal insufficiency"],"prefix":"10.1136","volume":"15","author":[{"given":"Joseph William","family":"Page","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Musgrove Park Hospital, Taunton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Drinkwater","sequence":"additional","affiliation":[{"name":"Bristol Medical School, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Furniss","sequence":"additional","affiliation":[{"name":"Musgrove Park Hospital, Taunton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Sahebjalal","sequence":"additional","affiliation":[{"name":"Musgrove Park Hospital, Taunton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"2025082709293208000_15.3.e248099.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv318"},{"key":"2025082709293208000_15.3.e248099.2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20274"},{"key":"2025082709293208000_15.3.e248099.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(93)90262-N"},{"key":"2025082709293208000_15.3.e248099.4","doi-asserted-by":"crossref","DOI":"10.1016\/S0735-1097(21)03785-2","article-title":"Addison\u2019s disease causing pericarditis with tamponade","volume":"77","author":"Jetty","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025082709293208000_15.3.e248099.5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1645"},{"key":"2025082709293208000_15.3.e248099.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2011.07.012"},{"key":"2025082709293208000_15.3.e248099.7","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1093\/humupd\/dmx014","article-title":"Non-Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency revisited: an update with a special focus on adolescent and adult women","volume":"23","author":"Carmina","year":"2017","journal-title":"Hum Reprod Update"},{"key":"2025082709293208000_15.3.e248099.8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-226826","article-title":"Bilateral adrenal myelolipomas presenting as acute adrenal insufficiency in an adult with congenital adrenal hyperplasia","volume":"12","author":"Suchartlikitwong","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082709293208000_15.3.e248099.9","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v3.i5.135"},{"key":"2025082709293208000_15.3.e248099.10","doi-asserted-by":"crossref","DOI":"10.1177\/2042018819848218","article-title":"Adrenal crisis: prevention and management in adult patients","volume":"10","author":"Dineen","year":"2019","journal-title":"Ther Adv Endocrinol Metab"},{"key":"2025082709293208000_15.3.e248099.11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1710"},{"key":"2025082709293208000_15.3.e248099.12","article-title":"Acute pericarditis as a presentation of adrenal insufficiency","volume":"10","author":"Manthri","year":"2018","journal-title":"Cureus"},{"key":"2025082709293208000_15.3.e248099.13","first-page":"264","article-title":"Stress response in critical illness","volume":"43","author":"Santos","year":"2013","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"key":"2025082709293208000_15.3.e248099.14","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/j.1365-2796.1997.tb00012.x","article-title":"Cardiac tamponade preceding adrenal insufficiency--an unusual presentation of Addison's disease: a report of two cases","volume":"241","author":"Torfoss","year":"1997","journal-title":"J Intern Med"},{"key":"2025082709293208000_15.3.e248099.15","doi-asserted-by":"crossref","unstructured":"Wang H , Feghali K , Jetty V . 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