{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:22:49Z","timestamp":1783084969924,"version":"3.54.6"},"reference-count":23,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,20]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Hypothyroidism is a common endocrine disorder with potential multi-system involvement. While pericardial effusion may occur in up to 30% of patients with hypothyroidism, cardiac tamponade is rare.<\/jats:p>\n                  <jats:p>We present a case of a woman in her mid 60s who came with complaints of progressive dyspnoea on exertion, apathy, cold intolerance and weight gain. Clinically, she was hypotensive, tachypnoeic and hypoxic but had a normal pulse rate. Echocardiography revealed massive pericardial effusion with cardiac tamponade. She was managed with urgent pericardiocentesis and oral thyroxine replacement.<\/jats:p>\n                  <jats:p>Cardiac tamponade is a medical emergency that necessitates immediate intervention. Our case underscores the need to suspect hypothyroidism as the underlying cause in a patient presenting with cardiac tamponade with a normal heart rate or bradycardia.<\/jats:p>","DOI":"10.1136\/bcr-2025-269352","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:55:45Z","timestamp":1783083345000},"page":"e269352","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac tamponade secondary to hypothyroidism"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8228-4177","authenticated-orcid":false,"given":"Asmita","family":"Samal","sequence":"first","affiliation":[{"name":"Medicine, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4683-2617","authenticated-orcid":false,"given":"Govind S","family":"Shiddapur","sequence":"additional","affiliation":[{"name":"Medicine, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4003-5981","authenticated-orcid":false,"given":"Akshay Anant","family":"Dhamne","sequence":"additional","affiliation":[{"name":"Medicine, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6957-9635","authenticated-orcid":false,"given":"Uttara","family":"Shankarnarayanan","sequence":"additional","affiliation":[{"name":"Medicine, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0867-8486","authenticated-orcid":false,"given":"Sonali","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Medicine, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5877-8187","authenticated-orcid":false,"given":"Diksha","family":"Sabharwal","sequence":"additional","affiliation":[{"name":"Medicine, Dr D Y Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026070305551317000_19.7.e269352.1","unstructured":"Jameson JL , Fauci AS , Kasper DL , et al . In: Loscalzo J , ed. Harrison\u2019s principles of internal medicine. New York: McGraw-Hill Education, 2022."},{"key":"2026070305551317000_19.7.e269352.2","unstructured":"Melmed S , Auchus RJ , Goldfine AB , et al . Rosen CJ, Editors.Williams Textbook of Endocrinology 14th ed. Philadelphia: Elsevier, 2024."},{"key":"2026070305551317000_19.7.e269352.3","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2018-314528"},{"key":"2026070305551317000_19.7.e269352.4","doi-asserted-by":"crossref","unstructured":"Bajaj R , Mehrzad R , Singh K , et al . Cardiac tamponade in hypothyroidism. BMJ Case Rep 2014;2014. doi:10.1136\/bcr-2014-204076","DOI":"10.1136\/bcr-2014-204076"},{"key":"2026070305551317000_19.7.e269352.5","doi-asserted-by":"crossref","unstructured":"Wiersinga WM . Hypothyroidism and myxedema coma. In: Jameson JL , ed. Endocrinology adult and pediatric. Philadelphia: Saunders, 2010: 1607\u201322.","DOI":"10.1016\/B978-1-4160-5583-9.00085-X"},{"key":"2026070305551317000_19.7.e269352.6","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.4103\/jmms.jmms_11_21","article-title":"Cardiac Tamponade as First Manifestation of Primary Hypothyroidism","volume":"24","author":"Shekhawat","year":"2022","journal-title":"Journal of Marine Medical Society"},{"key":"2026070305551317000_19.7.e269352.7","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4103\/2230-8210.83358","article-title":"Cardiac tamponade in a patient with primary hypothyroidism","volume":"15","author":"Patil","year":"2011","journal-title":"Indian J Endocr Metab"},{"key":"2026070305551317000_19.7.e269352.8","doi-asserted-by":"crossref","unstructured":"Ata F , Al-Hattab F , Bilal ABI . Ezeddin Alataresh, Haval Surchi, Cardiac Tamponade as a Harbinger of Hypothyroidism. JCEM Case Reports 2024. doi:10.1210\/jcemcr\/luae150","DOI":"10.1210\/jcemcr\/luae150"},{"key":"2026070305551317000_19.7.e269352.9","first-page":"2022","article-title":"Severe hypothyroidism presenting as cardiac tamponade","volume":"6","author":"Pathak","year":"2022","journal-title":"Am J Hosp Med"},{"key":"2026070305551317000_19.7.e269352.10","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1053\/j.jvca.2020.10.029","article-title":"Isolated Left Heart Tamponade on Echocardiography in Severe Pulmonary Hypertension and Right Heart Failure","volume":"35","author":"Poorsattar","year":"2021","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2026070305551317000_19.7.e269352.11","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s13019-023-02174-9","article-title":"Pericardial tamponade, a diagnostic chameleon: from the historical perspectives to contemporary management","volume":"PMCID","author":"Kaemmerer","year":"2023","journal-title":"J Cardiothorac Surg"},{"key":"2026070305551317000_19.7.e269352.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2007.00567.x"},{"key":"2026070305551317000_19.7.e269352.13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.16.1810"},{"key":"2026070305551317000_19.7.e269352.14","unstructured":"Bonow RO , Mann DL , Zipes DP . Braunwald's heart disease: A textbook of cardiovascular medicine. 13th edn. Philadelphia: Elsevier, 2025."},{"key":"2026070305551317000_19.7.e269352.15","doi-asserted-by":"crossref","first-page":"3952","DOI":"10.1093\/eurheartj\/ehaf192","article-title":"2025 ESC Guidelines for the management of myocarditis and pericarditis","volume":"46","author":"Schulz-Menger","year":"2025","journal-title":"Eur Heart J"},{"key":"2026070305551317000_19.7.e269352.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.06.023"},{"key":"2026070305551317000_19.7.e269352.17","unstructured":"Imazio M , Adler Y . Cardiac tamponade: a clinical challenge. E-Journal of Cardiology Practice 2017;15."},{"key":"2026070305551317000_19.7.e269352.18","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90853-2"},{"key":"2026070305551317000_19.7.e269352.19","unstructured":"Shamroth L . An introduction to electrocardiography. 7th edn. Oxford: Blackwell Scientific Publications, 1995."},{"key":"2026070305551317000_19.7.e269352.20","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.561514"},{"key":"2026070305551317000_19.7.e269352.21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.678326"},{"key":"2026070305551317000_19.7.e269352.22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjcr\/ytaa071","article-title":"Cardiac tamponade due to primary hypothyroidism: acute management and approach to prevent recurrence-a case report","volume":"4","author":"Maddali","year":"2020","journal-title":"Eur Heart J Case Rep"},{"key":"2026070305551317000_19.7.e269352.23","article-title":"Pericardial Effusion with Tamponade in Untreated Hypothyroidism","volume":"24","author":"Mujuni","year":"2023","journal-title":"Am J Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:55:59Z","timestamp":1783083359000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":23,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2025-269352"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269352","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}