Pericardial tamponade and excessive secretion of antidiuretic hormone

We have described a case of presumed excessive antidiuretic hormone (ADH) secretion due to pericardial effusion and tamponade. Pericardiotomy and drainage produced dramatic resolution of the antidiuresis. In the setting of pericardial tamponade, increased antidiuretic hormone secretion may be "appropriate" in response to overriding stimuli from the left atrial stretch receptors and carotid sinus baroreceptors.