Pericardial Tamponade Due to Synergistic Effects of Tuberculosis and Myxedema

Tuberculosis is a leading cause of massive pericardial effusion and tamponade especially in underdeveloped and developing countries. Hypothyroidism is also associated with pericardial effusion with rare progression to tamponade. We present a case of pericardial tamponade who diagnosed as both tuberculosis and myxedema at admission. Urgent pericardiocentesis performed as an initial therapy and four-agents antitu-berculous and thyroxine replacement therapy started immediately as long term management. Coexistance of tuberculosis and myxedema is a rare condition and they can cause tamponade formation with synergistic effect. Such a additive etiologies of pericardial tamponade have not been reported.