Thoracentesis-reverting cardiac tamponade physiology in a patient with myxedema coma and large pleural effusion.

Autor:	Werlang ME; Departments of Internal Medicine (Werlang) and Critical Care Medicine (Pimentel, Diaz-Gomez), Mayo Clinic, Jacksonville, Florida. Dr. Pimentel is currently at Irmandade Santa Casa de Misericordia, Porto Alegre, Brazil., Pimentel MR; Departments of Internal Medicine (Werlang) and Critical Care Medicine (Pimentel, Diaz-Gomez), Mayo Clinic, Jacksonville, Florida. Dr. Pimentel is currently at Irmandade Santa Casa de Misericordia, Porto Alegre, Brazil., Diaz-Gomez JL; Departments of Internal Medicine (Werlang) and Critical Care Medicine (Pimentel, Diaz-Gomez), Mayo Clinic, Jacksonville, Florida. Dr. Pimentel is currently at Irmandade Santa Casa de Misericordia, Porto Alegre, Brazil.
Jazyk:	angličtina
Zdroj:	Proceedings (Baylor University. Medical Center) [Proc (Bayl Univ Med Cent)] 2017 Jul; Vol. 30 (3), pp. 295-297.
DOI:	10.1080/08998280.2017.11929620
Abstrakt:	A large pleural effusion causing cardiac tamponade physiology and severe hemodynamic compromise is an uncommon event. We report a case of a 53-year-old woman with severe hypothyroidism presenting with myxedema coma and refractory shock. Her hemodynamic status failed to respond to fluid resuscitation and vasopressors. A transthoracic echocardiogram and chest radiograph demonstrated a pericardial fluid accumulation associated with a large left-sided pleural effusion. Thoracostomy tube insertion resulted in prompt improvement of the patient's hemodynamic status. Our finding demonstrates that a large pleural effusion may play an important role in cardiac tamponade physiology.
Databáze:	MEDLINE
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