Saeide Bahrani - Resident of cardiology, Isfahan university of medical sciences, Isfahan, Iran
Sayed Ali Emami - Medical doctor, Isfahan university of medical sciences, Isfahan, Iran
Mehrbod Vakhshoori - Medical doctor, Cardiac Rehabilitation Center, Isfahan Cardiovascular Research Institute, Isfahan university of medical sciences, Isfahan, Iran
Mansour Siavash - Endocrinologist, Isfahan university of medical sciences, Isfahan, Iran

Small pericardial effusion is a common finding in primary hypothyroidism, but massive pericardial effusion or tamponade is rare and associated with severe hypothyroidism. Herein, we describe a 56-year old diabetic man presented to emergency department with worsening of dyspnea over the past month. Echocardiography, electrocardiography and chest X-ray revealed massive pericardial effusion. Laboratory findings confirmed severe primary hypothyroidism and thyroid hormone replacement therapy was initiated. After pericardiocentesis, signs and symptoms improved. In conclusion, primary hypothyroidism should be considered in all patients presented with unexplained pericardial effusion.

Hypothyroidism; Pericardial effusion; Levothyroxine