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BMJ Case Rep. 2018 Feb 3;2018. pii: bcr-2017-223129. doi: 10.1136/bcr-2017-223129.

Sheehan's syndrome presenting as cardiac tamponade.

Author information

1
Medicine, All India Institute of Medical Sciences, New Delhi, India.
2
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Abstract

A 50-year-old woman presented with progressive dyspnoea and oedema with rapid deterioration over the last few days. Clinical examination revealed hypotension with cold clammy skin, raised jugular venous pressure and muffled heart sounds and was diagnosed to have cardiac tamponade, later confirmed on two-dimensional echocardiography. However, patient had bradycardia, and the other striking examination findings were coarse facies with pallor, madarosis, absent axillary and pubic hair and breast atrophy. Her blood sugar level was also low. Detailed history revealed an episode of postpartum haemorrhage with lactation failure and early menopause. Pericardiocentesis was done with a pig-tail catheter. Hormone profile and MRI brain confirmed the diagnosis of Sheehan's syndrome. Patient improved on treatment with thyroxine and hydrocortisone supplementation and was discharged with education about stress dosing.

KEYWORDS:

pericardial disease; pituitary disorders

PMID:
29431100
DOI:
10.1136/bcr-2017-223129
[Indexed for MEDLINE]

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