Hydropericardium in hypothyroidism. Features of the clinic, diagnosis and treatment

Abstract

Thyroid hormone deficiency negatively affects the state of the cardiovascular system, causing the formation of a «myxedematous heart». The frequency and clinical features of primary hypothyroidism in 84 patients discharged from the endocrinology department of the RCH in 2017-2022 were retrospectively analyzed. Pericardial effusion was registered in 9 people (10.7%). Massive effusion with separation of pericardial leaflets from 30 to 50 mm and the threat of tamponade was in 4 out of 9 patients. Even with a large volume of pericardial effusion, classic symptoms such as shortness of breath, orthopnea, chest pain, and a feeling of fullness were absent or poorly expressed. Differential diagnosis with diseases accompanied by accumulation of fluid in the pericardial cavity was required. Indicators of thyroid status made it possible to associate the hydropericardium with decompensation or hypothyroidism for the first time. Thyroid hormone replacement therapy led to the disappearance of hypothyroidism symptoms and a decrease in the hydropericardium. With a high risk of tamponade in 3 patients, therapy was supplemented with pericardiocentesis. A clinical observation of successful treatment with thyroid hormones in combination with pericardiocentesis of severe newly diagnosed hypothyroidism against the background of autoimmune thyroiditis with massive pericardial effusion is presented.