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Updated: Oct 27, 2025

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Massive left ventricular thrombosis in pericardial decompression syndrome
Andrew Curiale1, Srilakshmi Vallabhaneni1, Santo Longo2
1Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.
Background:
Pericardial decompression syndrome (PDS) is defined as paradoxical hemodynamic deterioration associated with left, right, or bi-ventricular dilation and systolic dysfunction following pericardiocentesis. It is uncommon yet under-recognized, underreported, and associated with significant morbidity and mortality.
Case Report:
We report a unique case of PDS associated with left ventricular (LV) systolic dysfunction and massive apical thrombosis following surgical removal of 800 ml of pericardial fluid in a 72-year-old man with undiagnosed lung cancer. Treatment with anticoagulation and anti-remodeling medications resulted in complete resolution of the thrombus and recovery of LV function.
Conclusions:
PDS, although rare, can lead to significant morbidity and mortality. Left ventricular apical thrombosis could result from PDS in the setting of hypercoagulable state. Treatment of the underlying disease may lead to successful resolution of PDS and its complications.
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