Das S, Lieberman A N, Schussler G C
Clin Cardiol. 1982 Aug;5(8):459-63. doi: 10.1002/clc.4960050810.
We describe clinical, echocardiographic, and catheterization findings that were present initially and during therapy in a myxedematous patient with a large pericardial effusion and tamponade. Treatment with thyroxine resulted in a marked improvement of most of the clinical features of hypothyroidism and some improvement in cardiac function. However, the pericardial effusion as well as clinical and laboratory evidence of tamponade persisted for 2 months after full replacement doses of T4 had been achieved. The tamponade was finally relieved by fenestration of the parietal pericardium. These findings are consistent with evidence of an abnormality of pericardial drainage that persists for months after other thyroid hormone dependent functions are normalized by thyroxine replacement. Therefore prompt surgical drainage rather than dependence on medical therapy alone is indicated in myxedematous patients who have cardiac tamponade.
我们描述了一名黏液性水肿患者最初及治疗期间出现的临床、超声心动图和心导管检查结果，该患者伴有大量心包积液和心脏压塞。甲状腺素治疗使大多数甲状腺功能减退的临床特征得到显著改善，心脏功能也有一定改善。然而，在达到完全替代剂量的T4后，心包积液以及心脏压塞的临床和实验室证据仍持续了2个月。最终通过心包开窗术缓解了心脏压塞。这些发现与心包引流异常的证据一致，即在通过甲状腺素替代使其他甲状腺激素依赖性功能恢复正常后，心包引流异常仍持续数月。因此，对于患有心脏压塞的黏液性水肿患者，应及时进行手术引流，而不是仅依赖药物治疗。
