{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:37:54Z","timestamp":1792291074501,"version":"4.4.0"},"reference-count":25,"publisher":"SMC Media","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Minoxidil is a direct-acting vasodilator that reduces systemic vascular resistance by opening adenosine triphosphate (ATP)-sensitive potassium channels, leading to arteriolar smooth muscle vasodilation. While commonly prescribed for resistant hypertension and androgenic alopecia, minoxidil is associated with fluid retention, and in rare cases, pericardial effusion that can progress to cardiac tamponade. In this report, we present a case of an 81-year-old male with a history of chronic kidney disease (CKD) who developed cardiac tamponade while on chronic minoxidil therapy for hypertension. He presented with progressive dyspnoea, lower extremity oedema, and fever. Imaging revealed an enlarged cardiac silhouette, and a confirmatory echocardiogram demonstrated a pericardial effusion with right ventricular collapse. The patient underwent urgent pericardiocentesis, yielding 545 ml of pericardial fluid. Infectious, malignant, and autoimmune aetiologies were ruled out, and minoxidil was identified as the likely cause. Following discontinuation of minoxidil, the patient\u2019s symptoms completely resolved, with no recurrence at 1-month follow-up. In addition, we reviewed 26 previously reported cases of minoxidil-induced pericardial effusion and\/or cardiac tamponade, 17 of which are summarized in this report. This case demonstrates the rare but potentially fatal complication of therapy and emphasizes the importance of early detection and clinical vigilance, particularly in vulnerable populations such as patients with CKD.<\/jats:p>","DOI":"10.12890\/2025_005379","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T04:49:45Z","timestamp":1746506985000},"source":"Crossref","is-referenced-by-count":3,"title":["Cardiac tamponade due to minoxidil use: a case report and review of the literature"],"prefix":"10.12890","volume":"12","author":[{"given":"Prami","family":"Nakarmi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Trinity Health Oakland Hospital, Pontiac, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Hermiz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Trinity Health Oakland Hospital, Pontiac, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopeessh","family":"Vempati","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Trinity Health Oakland Hospital, Pontiac, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanya","family":"Chandna","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Hospital, Cleveland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh","family":"Bhagat","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Hospital, Cleveland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy","family":"Loree","sequence":"first","affiliation":[{"name":"Department of Cardiology, Trinity Health Oakland Hospital, Pontiac, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Toquica Gahona","sequence":"first","affiliation":[{"name":"Department of Cardiology, Trinity Health Oakland Hospital, Pontiac, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"10.12890\/2025_005379_ref1","doi-asserted-by":"crossref","unstructured":"Bodson L, Bouferrache K, Vieillard-Baron A. Cardiac tamponade. Curr Opin Crit Care 2011;17:416-424. doi: 10.1097\/MCC.0b013e3283491f27","DOI":"10.1097\/MCC.0b013e3283491f27"},{"key":"10.12890\/2025_005379_ref2","doi-asserted-by":"crossref","unstructured":"Appleton C, Gillam L, Koulogiannis K. Cardiac Tamponade. Cardiol Clin 2017;35:525-537. doi: 10.1016\/j.ccl.2017.07.006","DOI":"10.1016\/j.ccl.2017.07.006"},{"key":"10.12890\/2025_005379_ref3","doi-asserted-by":"crossref","unstructured":"Zarate A, Gelfand MC, Horton JD, Winchester JF, Gottlieb MJ, Lazarus JM, et al. Pericardial effusion associated with minoxidil therapy in dialyzed patients. Int J Artif Organs 1980;3:15-17.","DOI":"10.1177\/039139888000300106"},{"key":"10.12890\/2025_005379_ref4","doi-asserted-by":"crossref","unstructured":"Wang T. The effects of the potassium channel opener minoxidil on renal electrolytes transport in the loop of henle. J Pharmacol Exp Ther 2003;304:833-840. doi: 10.1124\/jpet.102.043380","DOI":"10.1124\/jpet.102.043380"},{"key":"10.12890\/2025_005379_ref5","doi-asserted-by":"crossref","unstructured":"Reichgott MJ. Minoxidil and pericardial effusion: an idiosyncratic reaction. Clin Pharmacol Ther 1981;30:64-70. doi: 10.1038\/clpt.1981.128","DOI":"10.1038\/clpt.1981.128"},{"key":"10.12890\/2025_005379_ref6","doi-asserted-by":"crossref","unstructured":"Pasala KK, Gujja K, Prabhu H, Vasavada B, Konka S. Short-term minoxidil use associated with pericardial effusion and cardiac tamponade: an uncommon presentation. Am J Ther 2012;19:e186-8. doi: 10.1097\/MJT.0b013e3181f5371c","DOI":"10.1097\/MJT.0b013e3181f5371c"},{"key":"10.12890\/2025_005379_ref7","unstructured":"Krehlik JM, Hindson DA, Crowley JJ Jr, Knight LL. Minoxidil-associated pericarditis and fatal cardiac tamponade. West J Med 1985;143:527-529."},{"key":"10.12890\/2025_005379_ref8","unstructured":"Kadir S, Osinfade K, Lawal SO. Pericardial effusion associated with minoxidil therapy: case reports. West Afr J Med 1992;11:79-81."},{"key":"10.12890\/2025_005379_ref9","doi-asserted-by":"crossref","unstructured":"Marquez-Julio A, Uldall PR. Pericardial effusions associated with minoxidil. Lancet 1977;2:816-817. doi: 10.1016\/s0140-6736(77)90744-9","DOI":"10.1016\/S0140-6736(77)90744-9"},{"key":"10.12890\/2025_005379_ref10","doi-asserted-by":"crossref","unstructured":"Oye M, Oye M, Ali A. Signs of early cardiac tamponade induced by Minoxidil. Am J Emerg Med 2021;40:226.e1-226.e2. doi: 10.1016\/j.ajem.2020.07.050","DOI":"10.1016\/j.ajem.2020.07.050"},{"key":"10.12890\/2025_005379_ref11","doi-asserted-by":"crossref","unstructured":"Akinleye A, Jamil Y, Dogbey P. Minoxidil-Induced Pleuro-Pericardial Effusion With Tamponade. Cureus 2023;15:e46416. doi: 10.7759\/cureus.46416","DOI":"10.7759\/cureus.46416"},{"key":"10.12890\/2025_005379_ref12","doi-asserted-by":"crossref","unstructured":"Cilingiroglu M, Akkus N, Sethi S, Modi KA. Large pericardial effusion induced by minoxidil. Turk Kardiyol Dern Ars 2012;40:255-258. doi: 10.5543\/tkda.2012.63904","DOI":"10.5543\/tkda.2012.63904"},{"key":"10.12890\/2025_005379_ref13","unstructured":"Marquez-Julio A, From GL, Uldall PR. Minoxidil in refractory hypertension: benefits, risks. Proc Eur Dial Transplant Assoc 1977;14:501-508."},{"key":"10.12890\/2025_005379_ref14","doi-asserted-by":"crossref","unstructured":"Lundeen TE, Dolan DJ, Ram CV. Pericardial effusion associated with minoxidil therapy. Postgrad Med 1981;70:98-100. doi: 10.1080\/00325481.1981.11715906","DOI":"10.1080\/00325481.1981.11715906"},{"key":"10.12890\/2025_005379_ref15","unstructured":"Levy Y, Moskowitz M, Brook JG. [Massive pericardial effusion following minoxidil]. Harefuah 1989;116:581-582."},{"key":"10.12890\/2025_005379_ref16","doi-asserted-by":"crossref","unstructured":"Yasin M, Gyawali S, Khan A. Idiosyncratic Pericardial Effusion Associated With Minoxidil. Am J Ther 2018;25:e745-e747. doi: 10.1097\/MJT.0000000000000757","DOI":"10.1097\/MJT.0000000000000757"},{"key":"10.12890\/2025_005379_ref17","doi-asserted-by":"crossref","unstructured":"Spodick DH. Acute cardiac tamponade. N Engl J Med 2003;349:684-690. doi: 10.1056\/NEJMra022643","DOI":"10.1056\/NEJMra022643"},{"key":"10.12890\/2025_005379_ref18","doi-asserted-by":"crossref","unstructured":"Lew MJ, Amato J. Minoxidil-associated pericardial effusion and impending tamponade. JAAPA 2023;36:21-23. doi: 10.1097\/01.JAA.0000944608.70893.b3","DOI":"10.1097\/01.JAA.0000944608.70893.b3"},{"key":"10.12890\/2025_005379_ref19","doi-asserted-by":"crossref","unstructured":"Tr\u00fceb RM, Caballero-Uribe N, Luu NC, Dmitriev A. Serious complication of low- dose oral minoxidil for hair loss. JAAD Case Rep 2022;30:97-98. doi: 10.1016\/j.jdcr.2022.09.035","DOI":"10.1016\/j.jdcr.2022.09.035"},{"key":"10.12890\/2025_005379_ref20","doi-asserted-by":"crossref","unstructured":"Brondfield M, Wu L, Benowitz N. Minoxidil-Associated Pleuropericardial Effusion. J Gen Intern Med 2016;31:1105. doi: 10.1007\/s11606-016-3624-3","DOI":"10.1007\/s11606-016-3624-3"},{"key":"10.12890\/2025_005379_ref21","doi-asserted-by":"crossref","unstructured":"Gbadamosi WA, Melvin J, Lopez M. Atypical Case of Minoxidil-Induced Generalized Anasarca and Pleuropericardial Effusion. Cureus 2021;13:e15424. doi: 10.7759\/cureus.15424","DOI":"10.7759\/cureus.15424"},{"key":"10.12890\/2025_005379_ref22","doi-asserted-by":"crossref","unstructured":"Dlova NC, Jacobs T, Singh S. Pericardial, pleural effusion and anasarca: A rare complication of low-dose oral minoxidil for hair loss. JAAD Case Rep 2022;28:94-96. doi: 10.1016\/j.jdcr.2022.07.044","DOI":"10.1016\/j.jdcr.2022.07.044"},{"key":"10.12890\/2025_005379_ref23","doi-asserted-by":"crossref","unstructured":"Nautiyal A, Wong T, Kumar S, Mukherjee JT, Schick EC. Very large incidental pericardial effusion attributable to minoxidil: resolution without drainage. J Cardiovasc Med (Hagerstown) 2011;12:186-188. doi: 10.2459\/jcm.0b013e328334fb07","DOI":"10.2459\/JCM.0b013e328334fb07"},{"key":"10.12890\/2025_005379_ref24","doi-asserted-by":"crossref","unstructured":"Kolinsky DC, Kim AJ, Ablordeppey EA. Sub-acute Tamponade and the Value of Point-of-Care Ultrasound for Rapid Diagnosis: A Case Report. Clin Pract Cases Emerg Med 2017;1:232-237. doi: 10.5811\/cpcem.2017.3.33413","DOI":"10.5811\/cpcem.2017.3.33413"},{"key":"10.12890\/2025_005379_ref25","doi-asserted-by":"crossref","unstructured":"Webb DB, Whale RJ. Pleuropericardial effusion associated with minoxidil administration. Postgrad Med J 1982;58:319-320. doi: 10.1136\/pgmj.58.679.319","DOI":"10.1136\/pgmj.58.679.319"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5379\/4628","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5379\/4629","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5379\/4629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T09:29:59Z","timestamp":1755595799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/5379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.12890\/2025_005379","relation":{"has-manifestation":[{"id-type":"other","id":"1-126-5379-g4628","asserted-by":"subject"},{"id-type":"other","id":"1-126-5379-g4629","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-126","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}