Two-dimensional echocardiographic demonstration of left ventricular diastolic collapse due to compression by pleural effusion

Pleural effusion in the mechanically ventilated patient

“…Some cases presented with hemodynamic compromise that resolved after pleural drainage [37][38][39], whereas others exhibited right-sided chamber collapse without gross hemodynamic disturbances [40,41]. On the contrary, Alam et al [42] described three patients with PLEF after cardiac surgery who were unable to be weaned from vasoactive drugs.…”

Thoracentesis-Reverting Cardiac Tamponade Physiology in a Patient with Myxedema Coma and Large Pleural Effusion

“…During intrapleural fl uid infusion, intrapleural and intrapericardial pressures rose in the same manner (6). Subsequently, other case reports demonstrated the development of clinical echocardiographic and Doppler ultrasound signs of cardiac tamponade in patients with pleural eff usions and otherwise insignifi cant pericardial eff usions; drainage of pleural fl uid in these patients resulted in hemodynamic improvement (6)(7)(8)(9). As in our report, the tamponade physiology resolution after pleural eff usion drainage strongly suggests a direct and signifi cant eff ect of concomitant large pleural eff usions in addition to mild to moderate pericardial eff usions in causing tamponade as a severe hemodynamic complication.…”

“…However, even with a large pericardial eff usion, a left ventricular free wall collapse is uncommon (6). In 1991, Kisanuki et al (8) indicated that large pleural effusions can also be responsible for the clinical and echocardiographic signs of tamponade despite the traditional link between cardiac tamponade and accumulation of fl uid in the pericardial space. Experimental evidence in canine models corroborated the clinical experience, when euvolemic canines developed cardiac tamponade regardless of whether it was induced by intrapericardial or intrapleural fl uid infusion (6).…”

Pleural effusion causing cardiac tamponade: Report of two cases and review of the literature

“…Nevertheless, its association with pleural effusions has been only rarely discussed in the literature after its original description in 1991. 4 Kaplan et al 1 reported two patients with hypotension and right and left ventricular diastolic collapse. Alam et al 2 described three patients with pleural effusions after cardiac surgery who developed a clinical picture of cardiac tamponade and improved after thoracentesis.…”