[Massive pericardial effusion and cardiac tamponade as the presentation form of hypothyroidism]. / Derrame pericárdico masivo y taponamiento cardíaco como forma de presentación de hipotiroidismo.

We report a 43 years old female, admitted due to fatigability, asthenia and diffuse abdominal pain. On admission, obesity, slowness of thinking, bradycardia, distention of jugular veins and ascites were observed on physical examination. Laboratory showed undetectable thyroid hormone levels, a chest X ray showed bilateral pleural effusion and an enlarged heart. An echocardiography showed a massive pericardial effusion with collapse of the right atrium and dilatation of both caval veins. A pericardial tap was performed, draining 350 ml. Thyroid hormone substitution was started and after 12 months of follow up, the heart size decreased and a control echocardiogram showed a minimal pericardial effusion.

[Coronary stent placement for recurrent angina secondary to myocardial bridging]. / Implantación de stent coronario por angina de pecho recurrente secundaria a puente muscular.

Myocardial bridging of the epicardic coronary arteries is not an uncommon finding in angiographic or necropsic studies. Patients who have symptoms usually improve with medical treatment. However, in refractory patients a surgical myotomy of overlying myocardium and/or a coronary bypass may be needed. We report two patients with long myocardial bridges in the mid-left anterior descending coronary artery, who had recurrent angina refractory to conventional treatment. In both patients two consecutive coronary stents were successfully implanted. At five and six months follow-up they are asymptomatic and with good exercise tolerance.