Cardiac Tamponade as the Initial Presentation of Graves’ Disease: An Atypical Cardio-endocrine Emergency

We report the case of a 37-year-old woman with no prior comorbidities who presented with progressive breathlessness, cough, and fever. Clinical examination revealed icterus and bilateral pitting pedal edema. The patient had palpable axillary, cervical lymphadenopathy, and thyromegaly. Cardiovascular examination showed elevated jugular venous pressure with muffled heart sounds, suggestive of cardiac tamponade physiology. Further evaluation confirmed acute cardiac tamponade secondary to pericardial effusion in the setting of Graves’ disease. This presentation is rare and potentially life-threatening if not recognized and managed promptly. This case highlights an unusual cardiac manifestation of Graves’ disease and underscores the importance of considering endocrine etiologies, particularly thyrotoxicosis, while evaluating patients with pericardial effusion and cardiac tamponade.