Severe circulatory collapse immediately after pericardiocentesis in a patient with chronic cardiac tamponade.

ericardiocentesis and the removal of the fluid in patients with chronic cardiac tamponade may P cause acute pulmonary edema (1-3), acute right ventricular failure (4), ventricular tachycardia (5), and cardiac arrest (6). These complications, though rare, may occur during the rapid removal of the chronic cardiac effusion owing to sudden overload of the left ventricle secondary to an abrupt increase of venous return as well as increased sympathetic tone (1,2). We recently observed a severe cardiac collapse associated with significant ST-T changes after the removal of a large amount of chronic pericardial effusion in an adolescent girl. The present report emphasizes an additional potential danger of rapid removal of chronically accumulated pericardial effusion.

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