{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:14Z","timestamp":1787021234884,"version":"build-2736575974"},"reference-count":25,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HL45095"],"award-info":[{"award-number":["HL45095"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["73029"],"award-info":[{"award-number":["73029"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["135987"],"award-info":[{"award-number":["135987"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["92969"],"award-info":[{"award-number":["92969"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Thyroid hormone plays a critical role in cardiovascular function. Severe hypothyroidism can be associated with \u201cmyxedema heart\u201d characterized by relative bradycardia and pericardial effusion. Effusions associated with severe hypothyroidism can be large. Despite the large volume of effusions, tamponade is not a common consequence. However, with the incorporation of echocardiography into routine practice for evaluation of effusion, echocardiographic findings suggestive of clinical tamponade occur frequently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Description<\/jats:title>\n                    <jats:p>We report a series of 3 patients with large pericardial effusions secondary to severe hypothyroidism. These cases serve to demonstrate the discordance between echocardiographic signs consistent with tamponade with a patient\u2019s stable clinical hemodynamics. We also report the development of bronchial obstruction, a rare complication of a large effusion due to severe hypothyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While pericardial effusion associated with severe hypothyroidism has been described for decades, the echocardiographic findings may be less well known and may lead to unnecessary downstream testing or invasive management. We use our case series to facilitate a summary of what is known about the epidemiology, mechanism and physiology, and expected outcomes of myxedema associated pericardial effusion. Finally, in the setting of current paucity of clinical guidelines, we aim to familiarize clinicians with the phenomenon of pseudotamponade and suggest management strategies for myxedema associated pericardial effusion to guide clinicians to use conservative medical management in majority of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jendso\/bvaa125","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T09:17:13Z","timestamp":1598519833000},"source":"Crossref","is-referenced-by-count":13,"title":["Myxedema Heart and Pseudotamponade"],"prefix":"10.1210","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5529-2424","authenticated-orcid":false,"given":"Chelsey","family":"Baldwin","sequence":"first","affiliation":[{"name":"Divisions of Endocrinology, Diabetes, and Metabolism, New York University Grossman School of Medicine, New York, NY, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D","family":"Newman","sequence":"additional","affiliation":[{"name":"Divisions of Cardiology, New York University Grossman School of Medicine, New York, NY, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Vallejo","sequence":"additional","affiliation":[{"name":"Divisions of Endocrinology, Diabetes, and Metabolism, New York University Grossman School of Medicine, New York, NY, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Peck","sequence":"additional","affiliation":[{"name":"Divisions of Endocrinology, Diabetes, and Metabolism, New York University Grossman School of Medicine, New York, NY, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren Wissner","family":"Greene","sequence":"additional","affiliation":[{"name":"Divisions of Endocrinology, Diabetes, and Metabolism, New York University Grossman School of Medicine, New York, NY, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira J","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Divisions of Endocrinology, Diabetes, and Metabolism, New York University Grossman School of Medicine, New York, NY, US"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,8,27]]},"reference":[{"issue":"8","key":"2021121112515290600_CIT0001","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.amjmed.2014.03.009","article-title":"Thyroid and the heart","volume":"127","author":"Grais","year":"2014","journal-title":"Am J Med."},{"issue":"7","key":"2021121112515290600_CIT0002","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJM200102153440707","article-title":"Thyroid hormone and the cardiovascular system","volume":"344","author":"Klein","year":"2001","journal-title":"N Engl J 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