Division of Cardiology, Department of Medicine, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, South Korea.
Am J Case Rep. 2020 Jun 22;21:e923299. doi: 10.12659/AJCR.923299.
BACKGROUND Thyroid function is closely related to the cardiovascular system. Pericardial effusion is a well-known complication of hypothyroidism. It is common for massive pericardial effusion to progress to tamponed heart with hypotension, but not high blood pressure. CASE REPORT A 46-year-old woman presented to the hospital with dysarthria and left-side weakness of the upper limb which had started 30 minutes before her arrival at the hospital. The patient showed hypertensive emergency (213/124 mmHg) with intracerebral hemorrhage. Further evaluation for high blood pressure and transthoracic echocardiography demonstrated the presence of a large amount of pericardial effusion, and urgent pericardiocentesis was performed. The laboratory examination showed elevated thyroid-stimulating hormone and decreased free thyroxine level, leading to a diagnosis of primary hypothyroidism. The administration of current medications was maintained, including thyroid hormone replacement and anti-hypertensive drugs. CONCLUSIONS A rare case of profound hypothyroidism presenting with hypertensive crisis and massive pericardial effusion is described in this report.
甲状腺功能与心血管系统密切相关。心包积液是甲状腺功能减退的一种众所周知的并发症。大量心包积液进展为低血压伴心脏压塞并不少见，但不会出现高血压。
一名 46 岁女性因构音障碍和左侧上肢无力就诊，这些症状在她到达医院前 30 分钟开始出现。患者表现为高血压急症（213/124mmHg）合并脑出血。进一步评估高血压和经胸超声心动图显示存在大量心包积液，因此紧急进行了心包穿刺术。实验室检查显示促甲状腺激素升高和游离甲状腺素水平降低，从而诊断为原发性甲状腺功能减退症。维持了目前的药物治疗，包括甲状腺激素替代和抗高血压药物。
本报告描述了一例罕见的严重甲状腺功能减退症表现为高血压危象和大量心包积液的病例。
