Pericardial Decompression Syndrome After Drainage of Chronic Pericardial Effusions

Figures

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  Figure 1. Echocardiographic and Chest X-Ray Findings From Patient 1 (Top) Subxiphoid views of the pericardial effusion and mitral inflow velocity at 6 months before, at the time of, and immediately after pericardiocentesis. The asterisk indicates maximum mitral inflow velocity, and the open circle indicates minimum mitral inflow velocity. (A and B) Growth of the effusion with time. (B, C, E, F) Complete drainage of the effusion and resolution of the variation in mitral inflow after pericardiocentesis. (Bottom) Chest x-rays taken before pericardiocentesis and at the time signs and symptoms of PDS developed. (G, H) Smaller cardiac silhouette and slightly worse pulmonary edema after pericardiocentesis. 2D = 2-dimensional; MV = mitral valve.

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  Figure 2. Echocardiographic and Chest X-Ray Findings From Patient 2 (Top) Subxiphoid views of the pericardial effusion and mitral inflow velocity at 3 months before, at the time of, and immediately after pericardiocentesis. (Images of the effusion 20 months before presentation were not available.) The asterisk indicates maximum mitral inflow velocity, and the open circle indicates minimum mitral inflow velocity. (A, B) Growth of the effusion with time. (B, C, E, F) Complete drainage of the effusion with resolution of the variation in mitral inflow after pericardiocentesis. (Bottom) Chest x-rays taken before pericardiocentesis and at the time signs and symptoms of PDS developed. (G, H) Smaller cardiac silhouette, worsening pulmonary edema, and a new large right-sided pleural effusion after pericardiocentesis. 2D = 2-dimensional; MV = mitral valve.

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  Figure 3. Postulated Mechanisms of Pericardial Decompression Syndrome See text for details. RV = right ventricle.