RESUMEN
Hypothyroidism is a commonly encountered clinical diagnosis, particularly in the elderly population. While management of this disorder is rather simple with thyroxine replacement, healthcare providers may occasionally encounter patient non-adherence, which may lead to life-threatening complications. In this report, we present a case of a 74-year-old veteran with a long-standing history of amiodarone-induced asymptomatic hypothyroidism, who was non-adherent to thyroxine replacement therapy and presented to the hospital after a mechanical fall. His chest X-ray showed a globular heart with an enlarged cardiac silhouette, and transthoracic echocardiography (TTE) subsequently confirmed a large pericardial effusion with tamponade physiology. Physicians should be aware of and patients should be counseled about the potentially serious consequences of untreated hypothyroidism that could be avoided with proper patient education and adherence to the therapeutic plan.