Heart Failure due to Tension Hydrothorax after Left Pneumonectomy
DOI:
https://doi.org/10.1532/HSF98.2013225Abstract
Tension hydrothorax is a rare complication of pneumonectomy for pleural mesothelioma and an exceptionally rare cause of heart failure. We describe a patient who had undergone extrapleural pneumonectomy, chemotherapy, and radiation for pleural mesothelioma and who developed heart failure symptoms within months of the completion of treatment. Investigation showed a massive left pleural effusion resulting in tension hydrothorax, mediastinal shift, and evidence of right heart failure with constrictive physiology and low cardiac output. Therapeutic thoracentesis resulted in increase in cardiac output and symptomatic improvement.References
Gamez JM, Forteza JF. 2008. Cardiac tamponade secondary to pleural effusion in hepatopulmonary syndrome. Rev Esp Cardiol 61:1358-60.nKlopfenstein HS, Wann LS. 1994. Can pleural effusions cause tamponadelike effects? Echocardiography 11:489-92.nKopterides P, Lignos M, Papanikolaou S, et al. 2006. Pleural effusion causing cardiac tamponade: t of two cases and review of the literature. Heart Lung 35:66-7.nSawar A, Schocken DD. 2006. Cardiac tamponade complicating trimodal therapy for malignant mesothelioma. Heart Lung 35:355-7.nVaska K, Wann LS, Sagar K, Klopfenstein HS. 1992. Pleural effusion as a cause of right ventricular diastolic collapse. Circulation 86:609-17.nVenkatesh G, Tomlinson CW, O'Sullivan T, McKelvie RS. 1995. Right ventricular diastolic collapse without hemodynamic compromise in a patient with large, bilateral pleural effusions. J Am Soc Echocardiogr 8:551-3.n