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Sheehan’s syndrome presenting as cardiac tamponade
  1. Ankit Mittal1,
  2. Animesh Ray2,
  3. Ram Manohar Talupula1,
  4. Rita Sood1
  1. 1Medicine, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Ankit Mittal, mittalankit0505{at}


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.

  • pericardial disease
  • pituitary disorders

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  • Contributors All four authors were directly involved in patient care. AM and RMT: junior resident in-charge. AR: assistant professor in charge. RS: unit head and professor in charge. All four authors contributed to the writing. AM prepared the first draft and reviewed the literature. RMT helped with images and review. AR and RS helped in improving the layout and finalising the draft.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.